Precil Diego Miranda de Menezes Neves, Stanley Almeida Araújo, David Campos Wanderley, Andressa Monteiro Sodré, Marcos Adriano Garcia Campos, Elieser Hitoshi Watanabe, Denise Maria Avancini Costa Malheiros, Lívia Barreira Cavalcante, Felipe Lourenço Ledesma, Karla Cristina Petruccelli Israel, Flávia Lara Barcelos, Laila Lopes de Farias Pinho, Fabrício Augusto Marques Barbosa, Silvana Maria Carvalho Miranda, Márcio Dantas, Welluma Lomarques de Mendonça Britto, Jenaine Oliveira Paixão, Rafael Lage Madeira, Felipe Leite Guedes, Weverton Machado Luchi, Américo Lourenço Cuvello-Neto, Igor Denizarde Bacelar Marques, Jose Bruno Almeida, Rafael Fernandes Vanderlei Vasco, Antonio Monteiro, Francisco Rasiah Ladchumananandasivam, Antônio Augusto Lima Teixeira Júnior, Orlando Vieira Gomes, Rodrigo Hagemann, Oreste Angelo Ferra-Neto, Ricardo Ferreira Santos, Denise Maria do Nascimento Costa, Epitácio Rafael Luz-Neto, Leandro de Castro Bahia Alvarenga Soares, Rebecca Souza Mubarac, Kellen Micheline Alves Henrique Costa, Rafael Weissheimer, Christiany Moreira Almeida, Barbara Antunes Bruno da Silva, Leandro Santos Miranda, Leandro Rodrigues Iannuzzi, Gilson Masahiro Murata, Irene de Lourdes Noronha, Natalino Salgado-Filho, Luiz Fernando Onuchic, Gyl Eanes de Barros Silva
{"title":"在covid -19相关肾病患者中，微小病变和局灶节段性肾小球硬化与良好的肾脏预后和血栓性微血管病变与较差的肾脏存活率相关。","authors":"Precil Diego Miranda de Menezes Neves, Stanley Almeida Araújo, David Campos Wanderley, Andressa Monteiro Sodré, Marcos Adriano Garcia Campos, Elieser Hitoshi Watanabe, Denise Maria Avancini Costa Malheiros, Lívia Barreira Cavalcante, Felipe Lourenço Ledesma, Karla Cristina Petruccelli Israel, Flávia Lara Barcelos, Laila Lopes de Farias Pinho, Fabrício Augusto Marques Barbosa, Silvana Maria Carvalho Miranda, Márcio Dantas, Welluma Lomarques de Mendonça Britto, Jenaine Oliveira Paixão, Rafael Lage Madeira, Felipe Leite Guedes, Weverton Machado Luchi, Américo Lourenço Cuvello-Neto, Igor Denizarde Bacelar Marques, Jose Bruno Almeida, Rafael Fernandes Vanderlei Vasco, Antonio Monteiro, Francisco Rasiah Ladchumananandasivam, Antônio Augusto Lima Teixeira Júnior, Orlando Vieira Gomes, Rodrigo Hagemann, Oreste Angelo Ferra-Neto, Ricardo Ferreira Santos, Denise Maria do Nascimento Costa, Epitácio Rafael Luz-Neto, Leandro de Castro Bahia Alvarenga Soares, Rebecca Souza Mubarac, Kellen Micheline Alves Henrique Costa, Rafael Weissheimer, Christiany Moreira Almeida, Barbara Antunes Bruno da Silva, Leandro Santos Miranda, Leandro Rodrigues Iannuzzi, Gilson Masahiro Murata, Irene de Lourdes Noronha, Natalino Salgado-Filho, Luiz Fernando Onuchic, Gyl Eanes de Barros Silva","doi":"10.1159/000542836","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The kidney is a frequent target of SARS-CoV-2, potentially developing lesions in glomeruli, vessels, and tubulointerstitium in response to this infection. Herein, we present the analysis of the first large Latin American cohort of adult patients undergoing kidney biopsy due to COVID-19-associated kidney disorders.</p><p><strong>Methods: </strong>This retrospective, multicenter, national study was based on the collection of information on demographics, comorbidities, laboratory data, kidney histology, therapy, and therapeutic response. Patients diagnosed with collapsing glomerulopathy (CG) were genotyped for APOL1.</p><p><strong>Results: </strong>Our cohort included 94 patients, most male (62.8%). The median age was 44 (33-52) years, and 50% of them were previously hypertensive. The time between COVID-19 diagnosis and kidney biopsy was 30 (15-60) days. Most patients had decreased kidney function at diagnosis, 43.5% required dialysis upon diagnosis, 77.6% received immunosuppression, and 2/3 achieved a clinical remission. CG was the most common kidney involvement (18 cases), reproducing previous findings. Focal segmental glomerulosclerosis (FSGS), thrombotic microangiopathy (TMA), and IgA nephropathy were also frequent, with 10 cases each. FSGS and minimal change disease (MCD) were associated with the best cumulative kidney survival; none started dialysis. In contrast, patients with TMA/C3 glomerulopathy presented a poor kidney prognosis, with more than half progressing to kidney replacement therapy.</p><p><strong>Conclusion: </strong>A novel and striking finding of our study, therefore, was the association of FSGS and MCD with the best kidney outcome among all COVID-19-related histological patterns. Moreover, the overall distribution of histological profiles showed significant particularities in the analyzed patient cohort, the most important being the higher frequency of TMA cases.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1-17"},"PeriodicalIF":4.3000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Minimal Change Disease and Focal Segmental Glomerulosclerosis Are Associated with Good Kidney Prognosis and Thrombotic Microangiopathy with Poor Kidney Survival in Patients with COVID-19-Associated Nephropathies.\",\"authors\":\"Precil Diego Miranda de Menezes Neves, Stanley Almeida Araújo, David Campos Wanderley, Andressa Monteiro Sodré, Marcos Adriano Garcia Campos, Elieser Hitoshi Watanabe, Denise Maria Avancini Costa Malheiros, Lívia Barreira Cavalcante, Felipe Lourenço Ledesma, Karla Cristina Petruccelli Israel, Flávia Lara Barcelos, Laila Lopes de Farias Pinho, Fabrício Augusto Marques Barbosa, Silvana Maria Carvalho Miranda, Márcio Dantas, Welluma Lomarques de Mendonça Britto, Jenaine Oliveira Paixão, Rafael Lage Madeira, Felipe Leite Guedes, Weverton Machado Luchi, Américo Lourenço Cuvello-Neto, Igor Denizarde Bacelar Marques, Jose Bruno Almeida, Rafael Fernandes Vanderlei Vasco, Antonio Monteiro, Francisco Rasiah Ladchumananandasivam, Antônio Augusto Lima Teixeira Júnior, Orlando Vieira Gomes, Rodrigo Hagemann, Oreste Angelo Ferra-Neto, Ricardo Ferreira Santos, Denise Maria do Nascimento Costa, Epitácio Rafael Luz-Neto, Leandro de Castro Bahia Alvarenga Soares, Rebecca Souza Mubarac, Kellen Micheline Alves Henrique Costa, Rafael Weissheimer, Christiany Moreira Almeida, Barbara Antunes Bruno da Silva, Leandro Santos Miranda, Leandro Rodrigues Iannuzzi, Gilson Masahiro Murata, Irene de Lourdes Noronha, Natalino Salgado-Filho, Luiz Fernando Onuchic, Gyl Eanes de Barros Silva\",\"doi\":\"10.1159/000542836\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The kidney is a frequent target of SARS-CoV-2, potentially developing lesions in glomeruli, vessels, and tubulointerstitium in response to this infection. Herein, we present the analysis of the first large Latin American cohort of adult patients undergoing kidney biopsy due to COVID-19-associated kidney disorders.</p><p><strong>Methods: </strong>This retrospective, multicenter, national study was based on the collection of information on demographics, comorbidities, laboratory data, kidney histology, therapy, and therapeutic response. Patients diagnosed with collapsing glomerulopathy (CG) were genotyped for APOL1.</p><p><strong>Results: </strong>Our cohort included 94 patients, most male (62.8%). The median age was 44 (33-52) years, and 50% of them were previously hypertensive. The time between COVID-19 diagnosis and kidney biopsy was 30 (15-60) days. Most patients had decreased kidney function at diagnosis, 43.5% required dialysis upon diagnosis, 77.6% received immunosuppression, and 2/3 achieved a clinical remission. CG was the most common kidney involvement (18 cases), reproducing previous findings. Focal segmental glomerulosclerosis (FSGS), thrombotic microangiopathy (TMA), and IgA nephropathy were also frequent, with 10 cases each. FSGS and minimal change disease (MCD) were associated with the best cumulative kidney survival; none started dialysis. In contrast, patients with TMA/C3 glomerulopathy presented a poor kidney prognosis, with more than half progressing to kidney replacement therapy.</p><p><strong>Conclusion: </strong>A novel and striking finding of our study, therefore, was the association of FSGS and MCD with the best kidney outcome among all COVID-19-related histological patterns. Moreover, the overall distribution of histological profiles showed significant particularities in the analyzed patient cohort, the most important being the higher frequency of TMA cases.</p>\",\"PeriodicalId\":7570,\"journal\":{\"name\":\"American Journal of Nephrology\",\"volume\":\" \",\"pages\":\"1-17\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-12-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000542836\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000542836","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Minimal Change Disease and Focal Segmental Glomerulosclerosis Are Associated with Good Kidney Prognosis and Thrombotic Microangiopathy with Poor Kidney Survival in Patients with COVID-19-Associated Nephropathies.
Introduction: The kidney is a frequent target of SARS-CoV-2, potentially developing lesions in glomeruli, vessels, and tubulointerstitium in response to this infection. Herein, we present the analysis of the first large Latin American cohort of adult patients undergoing kidney biopsy due to COVID-19-associated kidney disorders.
Methods: This retrospective, multicenter, national study was based on the collection of information on demographics, comorbidities, laboratory data, kidney histology, therapy, and therapeutic response. Patients diagnosed with collapsing glomerulopathy (CG) were genotyped for APOL1.
Results: Our cohort included 94 patients, most male (62.8%). The median age was 44 (33-52) years, and 50% of them were previously hypertensive. The time between COVID-19 diagnosis and kidney biopsy was 30 (15-60) days. Most patients had decreased kidney function at diagnosis, 43.5% required dialysis upon diagnosis, 77.6% received immunosuppression, and 2/3 achieved a clinical remission. CG was the most common kidney involvement (18 cases), reproducing previous findings. Focal segmental glomerulosclerosis (FSGS), thrombotic microangiopathy (TMA), and IgA nephropathy were also frequent, with 10 cases each. FSGS and minimal change disease (MCD) were associated with the best cumulative kidney survival; none started dialysis. In contrast, patients with TMA/C3 glomerulopathy presented a poor kidney prognosis, with more than half progressing to kidney replacement therapy.
Conclusion: A novel and striking finding of our study, therefore, was the association of FSGS and MCD with the best kidney outcome among all COVID-19-related histological patterns. Moreover, the overall distribution of histological profiles showed significant particularities in the analyzed patient cohort, the most important being the higher frequency of TMA cases.
期刊介绍：
The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including:
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