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M94A0062.TXT
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1994-10-01
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Document 0062
DOCN M94A0062
TI Collapsing glomerulopathy: a clinically and pathologically distinct
variant of focal segmental glomerulosclerosis.
DT 9412
AU Detwiler RK; Falk RJ; Hogan SL; Jennette JC; Department of Medicine,
University of North Carolina, Chapel; Hill.
SO Kidney Int. 1994 May;45(5):1416-24. Unique Identifier : AIDSLINE
MED/94351995
AB Sixteen patients with renal biopsy findings of extensive focal
glomerular capillary collapse, visceral epithelial cell hypertrophy and
hyperplasia, and variable degrees of tubulointerstitial injury in the
absence of evidence for human immunodeficiency virus (HIV) infection or
intravenous drug abuse were prospectively identified by renal biopsy.
The pathologic process was designated collapsing glomerulopathy to
distinguish it from other patterns of focal glomerular sclerosis. The
clinical and pathologic characteristics of these 16 patients were
analyzed and compared to a group of 25 patients with noncollapsing focal
segmental glomerulosclerosis (FSGS). Thirteen of 16 patients with
collapsing glomerulopathy were black as compared with 11 of 25 with FSGS
(P = 0.018). The most common findings at presentation were hypertension
and manifestations of the nephrotic syndrome. Although the duration of
symptoms prior to presentation was no longer in the collapsing
glomerulopathy group, the presenting mean serum creatinine was higher in
patients with collapsing glomerulopathy than in those with noncollapsing
FSGS (3.5 +/- 3.4 mg/dl vs. 1.3 0.6 mg/dl, P = 0.001). Twenty-four-hour
urine protein excretion was also higher in the collapsing glomerulopathy
group (13.2 +/- 7.7 g/day vs. 4.6 +/- 4.5 g/day FSGS, P = 0.005). The
collapsing glomerulopathy patients had a mean age of 41.4 +/- 19.1
(range 19 to 81), a male-to-female ratio of 11:5 and a black-to-white
ratio of 13:3. Renal survival, evaluated by life-table analysis, was
markedly worse in collapsing glomerulopathy patients than in FSGS
patients (P = 0.0004). It is proposed that collapsing glomerulopathy is
a distinct entity characterized by black racial predominance, massive
proteinuria, relatively rapidly progressive renal insufficiency, and
distinctive pathologic findings.(ABSTRACT TRUNCATED AT 250 WORDS)
DE Adult Aged Aged, 80 and over Capillaries/PATHOLOGY
Epithelium/PATHOLOGY Female Glomerulosclerosis, Focal/*PATHOLOGY
Human Hypertrophy Kidney Diseases/PATHOLOGY Kidney Glomerulus/*BLOOD
SUPPLY Male Middle Age JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).