Clinicopathological characteristics and outcomes of patients with unexplained renal impairment: A single center study

IF 2 4区医学 Q2 UROLOGY & NEPHROLOGY

Nefrologia Pub Date : 2025-03-01 DOI:10.1016/j.nefro.2024.10.006

Radwa A. Ellisy , Effat A. Tony , Wesam Ismail , Rabab Radi , Mohamed Ismail Seddik , Essam M. Abdel Aziz

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引用次数: 0

Abstract

Background

Chronic kidney disease (CKD) is a growing health problem. About 20% of CKD patients have undetermined causes. Data describing histopathological patterns of unexplained impaired kidney functions in Egypt are lacking. We aimed to identify the clinicopathological characteristics and short-term outcomes of adult cases with unexplained impaired kidney functions.

Methods

We conducted a prospective study in Assiut University Hospital from August 2018 to May 2022. It included patients with unexplained elevated serum creatinine (serum creatinine > 115 μmol/L) who underwent renal biopsies. Descriptive statistics were used to summarize data on patient demographics, histopathological patterns, and outcomes after three months. Clinical trial registration number: NCT03586531.

Results

Overall, 210 native renal biopsies were included in the analysis. Glomerular diseases were the most common pathological finding (n = 88, 44.9%), amyloidosis and FSGS were the most prevalent glomerular pathology (15.2%, 14.3%, respectively). Chronic kidney disease of unknown etiology (CKDu) was diagnosed in 8.1% of the cases; histology suggestive of genetic origin was found in 2.5%, and LECT amyloidosis was found in 3.8% of the cases. Poor outcomes were observed in 43.6% of the patients i.e., renal replacement therapy or death. Treatment strategies were changed based on the biopsy findings in 86 patients (40%).

Conclusion

Amyloidosis and FSGS were the most common causes of unexplained renal impairment. CKDu is not uncommon in Egypt, and more preventive measures are needed. This study supports the irreplaceable role of renal biopsy in disease diagnosis, treatment decisions, and predicting prognosis even in advanced stages.

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不明原因肾损害患者的临床病理特征和预后：单中心研究

慢性肾脏疾病（CKD）是一个日益严重的健康问题。大约20%的CKD患者病因不明。缺乏描述埃及不明原因肾功能受损的组织病理学模式的数据。我们的目的是确定临床病理特征和短期预后的成人病例不明原因的肾功能受损。方法于2018年8月至2022年5月在阿西尤特大学医院进行前瞻性研究。其中包括原因不明的血清肌酐升高(血清肌酐>；115 μmol/L)，行肾活检。描述性统计用于总结三个月后患者人口统计学、组织病理学模式和结果的数据。临床试验注册号：NCT03586531。结果总共有210例本地肾活检纳入分析。肾小球疾病是最常见的病理表现（n = 88, 44.9%），淀粉样变和FSGS是最常见的肾小球病理（分别为15.2%,14.3%）。8.1%的病例诊断为病因不明的慢性肾病（CKDu）；2.5%的组织学提示遗传起源，3.8%的病例发现LECT淀粉样变。43.6%的患者预后不良，即肾替代治疗或死亡。根据86例（40%）患者的活检结果改变治疗策略。结论淀粉样变和FSGS是导致不明原因肾功能损害最常见的原因。CKDu在埃及并不罕见，需要更多的预防措施。本研究支持肾活检在疾病诊断、治疗决策和预测晚期预后中不可替代的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nefrologia 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

7.70%

发文量

148

审稿时长

47 days

期刊介绍： Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.