间质纤维化评分在不同病理类型所致的肾病综合征患者中的临床意义及其与肾脏预后的关系

目的 分析间质纤维化评分在不同病理类型所致的肾病综合征患者中的临床意义及其与肾脏预后的关系.方法 选取2016年5月至2018年9月本院收治的298例肾病综合征患者,包括经活检证实的微小病变肾病(MCD)患者92例、局灶节段性肾小球硬化(FSGS)患者114例、膜性肾病(MN)患者56例和IgA肾病(IgAN)患者36...

The significance of interstitial fibrosis score in patients with nephrotic syndrome caused by different pathological types and its relationship with renal prognosis

Objective To analyze the significance of interstitial fibrosis score in patients with nephrotic syndrome caused by different pathological types and its relationship with renal prognosis.Methods We studied 298 patients,including biopsied minimal change disease(M CD,92 cases),focal segular glomerular sclerosis(FSGS,114 cases),membranous nephropathy(MN,56 cases),and IgA nephropathy(IgA N,36 cases)from May 2016 to September 2018.Cortical interstitial fibrosis(IF),tubular atrophy(TA),and interstitial inflammation(II)were quantified on digitized full-slide biopsy images by five pathologists with high reader consistency(intra-class correlation coefficient>0.8)(%).Multivariate Cox proportional hazard regression models were used to assess IF was association with estimated glomenilar filtration rate(eG FR)reduction of 40%,end-stage renal disease(ESRD),and albuminuria complete remission(C R).Results IF was highly correlated with as(P<0.001)and D(P<0.001),IF medians varied from diagnosis:FSGS 17,IgAN 21,MN 7,MCD 1(P<0.001).IF was strongly correlated with baseline eGFR(P<0.001)and albuminuria(P<0.001),After adjusting for clinicopathologic diagnosis,age,GS,baseline proteinuria and eGFR,the risk ratio for each 10%increase in IF(P<0.001),but there was no significant correlation with CR.Conclusions The degree of IF is associated with the risk of decreased eGFR in different types of proteinuria glomerular disease,associated with inflammation and may be predictive in assessing the risk of progression.