Premium
Outcomes of immunoglobulin‐associated mesangiocapillary glomerulonephritis: A South African experience
Author(s) -
Chothia MogamatYazied,
Panday Amaan Shabeer,
Coetzee Liezel,
Bates William
Publication year - 2020
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13736
Subject(s) - medicine , glomerulonephritis , proportional hazards model , creatinine , biopsy , rapidly progressive glomerulonephritis , clinical endpoint , cyclophosphamide , renal biopsy , gastroenterology , kidney , chemotherapy , clinical trial
Aim Immunoglobulin‐associated mesangiocapillary glomerulonephritis is currently the most common biopsy‐confirmed glomerulonephritis in Cape Town, South Africa. We aimed to determine the outcome of patients with a biopsy‐confirmed diagnosis of immunoglobulin‐associated mesangiocapillary glomerulonephritis at our centre. Methods A retrospective cohort study of adult patients was conducted from January 1, 2000 to December 31, 2016. The endpoint was a composite of doubling of creatinine and/or end‐stage renal disease and/or death. Cox univariable and multivariable proportional hazards models were used to examine the association between the composite endpoint and predictor variables. Survival curves were made with the use of Kaplan‐Meier estimates. Results A total of 70 patients were included in the study and their median duration of follow‐up was 30.4 months. Forty‐eight (68.6%) patients reached the composite endpoint. The proportion reaching this endpoint at 1, 3 and 5 years were 37.5%, 64.6% and 81.3%, respectively. Cox multivariable proportional hazards model identified a serum creatinine concentration > 200 μmol/L at the time of biopsy, moderate to severe interstitial fibrosis, ≥50% crescents and cyclophosphamide therapy as predictors of the composite endpoint. Conclusion Immunoglobulin‐associated mesangiocapillary glomerulonephritis remains a common glomerular pathological diagnosis in our setting and has poor outcomes. This may partially be explained by late presentation. Future research needs to focus on identifying the possible cause(s) of this common glomerular disease so that more targeted therapeutic approaches can be offered.