Abstract: SA-PO719
Epidemiology of Membranoproliferative Glomerulonephritis: A Single Centre Observation Over 20 Years
Session Information
- Glomerular Diseases: Clinical, Outcomes, Trials - III
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials
Authors
- Ramakrishna, Chethana, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Storrar, Joshua, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Metaoy, Sara, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Chrysochou, Constantina, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Rainone, Francesco, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Ritchie, James, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Poulikakos, Dimitrios J., Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Chinnadurai, Rajkumar, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Kalra, Philip A., Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
- Sinha, Smeeta, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
Background
Membranoproliferative glomerulonephritis (MPGN) is a pathological entity seen on light microscopy which represents a pattern of kidney injury characterised by an increase in intraglomerular cells and diffuse thickening of the glomerular capillary walls. MPGN accounts for about 7% -10% of all cases of confirmed glomerulonephritis on biopsy. MPGN includes immune complex mediated MPGN (ICGN) and C3 glomerulopathy (C3G). C3G in turn comprises of dense deposit disease (DDD) and C3 glomerulonephritis (C3GN).The updated classification has enabled a greater understanding of the pathophysiology and facilitated research focusing on targeted therapeutic options and trials particularly targeting the complement system
Methods
This is a single centre observational study was conducted on all patients who had a biopsy proven diagnosis of MPGN from our biopsy database between January 2000 and December 2020
Results
A total of 41 patients were diagnosed with MPGN over this 20-year period of which 28 patients had immune complex mediated MPGN and 10 patients had C3G. Of the patients with C3G, 8 had C3GN and 2 had DDD. Three patients with MPGN were not classified due to insufficient data. The mean age at diagnosis was 55.7 ±17.6 years. Mean age at diagnosis for ICGN and C3G was 56.8 ± 16.9 years and 48 ± 17.9 years respectively. Mean blood pressure was 147/81 mmHg ±27/11mmHg.
Nephrotic range proteinuria was the presenting feature in 14 patients with ICGN and 7 patients with C3G. MPGN was associated with infections in 8 patients, connective tissue disease in 5 patients and haematological malignancies (lymphoma/leukaemia) in 5 patients. The remaining 23 patients did not have a clear aetiology for MPGN.
The mean estimated glomerular filtration rate was 40.3 ±27.8 mL/min at diagnosis; 80.4% received renin-angiotensin system inhibitors (RASi) and 73.17% received immunosuppression. Twenty patients (50%) progressed to end stage kidney disease and received renal replacement therapy. Two patients underwent renal transplantation of which one developed recurrence of MPGN in the transplant kidney.
Conclusion
Our observation has added insights to this rare renal pathological diagnosis which has multiple aetiological factors including complement pathway dysregulation.