Abstract:
BACKGROUND:Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. METHODS:The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. RESULTS:Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. CONCLUSION:According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Payan Schober F,Jobson MA,Poulton CJ,Singh HK,Nickeleit V,Falk RJ,Jennette JC,Nachman PH,Pendergraft Iii WFdoi
10.1159/000455390subject
Has Abstractpub_date
2017-01-01 00:00:00pages
248-256issue
3eissn
0250-8095issn
1421-9670pii
000455390journal_volume
45pub_type
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013411
更新日期:1998-01-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1159/000168725
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journal_title:American journal of nephrology
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doi:10.1159/000315856
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journal_title:American journal of nephrology
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更新日期:2015-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2013-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000097815
更新日期:2006-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2014-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:1987-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166931
更新日期:1985-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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