Clinical Significance of Hilar Hyalinosis in Glomeruli of Children with Idiopathic Nephrotic Syndrome
Journal Title: Archives of Renal Diseases and Management - Year 2015, Vol 1, Issue 1
Abstract
Introduction: Hilar hyalinosis (HH) of glomeruli has been thought for a long time to be a precursor or a variant of focal glomerulosclerosis (FGS). In view of its implications on treatment and prognosis of nephrotic syndrome, a retrospective study of hilar hyalinosis in children with the idiopathic nephrotic syndrome (INS), but without any other histologic evidence of FGS, was performed to determine the clinic-pathologic significance of this lesion. Methods: A total of 92 Children with INS who had kidney biopsies for frequent relapses, steroid dependency or resistance were included. Eight of them had a biopsy-proven diagnosis of either minimal change disease or mild IgM nephropathy with HH in 6-25% of glomeruli were compared to control group consisting of 84 children with either minimal change disease (n=57) or IgM nephropathy (n=27) but without HH. Results: Clinically HH patients presented with NS and followed a steroid-dependent relapsing course prior to biopsy. Around 75% of the HH patients received at least one course of cytotoxic therapy after biopsy. At last visit, 6 patients were in remission, 2 were protein-free but on medication. None had hypertension or renal insufficiency. Apart from having a shorter interval between presentation and biopsy (P<0.001) and a lower remission rate (P<0.05), control patients followed a similar course. Pathologically HH patients showed less mesangial change (P<0.001) than the controls but similar mean glomerular size and tubuloinerstitial damage. Conclusion: The results do not support the concept of HH being a precursor lesion of FGS.
Authors and Affiliations
AAl-Eisa Amal, D’souza Thomas M
Keywords
Related Articles
- EP ID EP343343
- DOI 10.17352/2455-5495.000003
- Views 76
- Downloads 0
Persistent hypocomplementemia in a 9 year old boy following acute post-streptococcal glomerulonephritis
Acute post-streptococcal glomerulonephritis (APSGN) is still common in our region and it is characterized by acute onset of edema, gross hematuria, hypertension, acute kidney injury and temporary hypocomplementemia with...
Factors related to the progression of Chronic Kidney Disease after two years of follow-up of stage 3 Chronic kidney Disease Patients
Background: The problem of chronic kidney disease (CKD) progression is a panic and it is still inevitable. Patients and Methods: Prospective observational study of factors present at initial evaluation of stage 3 CKD pat...
Massive Carbon Dioxide Embolism during Pneumoperitoneum for Laparoscopic Adrenalectomy
A 65-year-old man, with suspected right adrenal metastasis from hepatic carcinoma, was scheduled to undergo a laparoscopic right adrenalectomy. About 75 minutes into the operation, when attempting to remove the adrenal g...
Use of Interpreters for non-native English speaking Kidney Allograft Recipients and outcomes after Kidney Transplantation
Background: Language barriers are associated with worse health outcomes in the general population but data in kidney transplantation is lacking. This study tested the hypothesis that non-native English speakers using int...
Effects of Anabolic Androgenic Steroids on Renal Morphology in Rats
Aim: To investigate the long-term effects of anabolic androgenic steroids (AAS) on renal status in rats. Methods: Twenty Wistar rats were distributed into 2 groups: AAS or placebo, for 3 months. The animal received 10mg...