Sales Fernando, Carmo Priscylla Vieira do, Huaira Rosália Maria Nunes Henriques, Almeida Nicolas William Gonçalves de, Lourenço Mateus Henrique Toledo, Fernandes Natália Maria da Silva
Universidade Federal de Juíz de Fora, Hospital Universitário, Juiz de Fora, MG, Brazil.
J Bras Nefrol. 2025 Oct-Dec;47(4):e20240213. doi: 10.1590/2175-8239-JBN-2024-0213en.
Glomerular diseases (GD) are an important cause of chronic kidney disease (CKD). This study aims to analyze the socio-demographic, clinical, and renal outcome profiles of patients with GD.
A retrospective cohort study was conducted between 1998 and 2023. Participants were patients aged ≥ 18 years, diagnosed with GD, and treated at a university hospital in Brazil. Socio-demographic, clinical, histopathological, and kidney variables were analyzed. A comparative analysis was performed among the most frequent histopathological diagnoses. Renal survival was the outcome variable.
We evaluated 417 patients, of whom 57.3% were women and 69.8% were white. The mean age was 41.7 ± 14.4 years. Primary glomerular diseases (PGD) accounted for 51.1%, and 77.5% of patients underwent a kidney biopsy. The most frequent PGD was membranous nephropathy (26.3%), while among the secondary glomerular diseases (SGD), lupus nephritis (LN) was the most common (51.9%). Minimal change disease was associated with better renal survival, whereas membranoproliferative glomerulonephritis had the worst outcomes (p = 0.001). Regarding CKD progression, a higher initial estimated glomerular filtration rate (eGFR) was protective (HR = 0.956, 95%CI: 0.920-0.994; p = 0.023), while the presence of interstitial fibrosis/tubular atrophy (IFTA) (HR = 1.079, 95%CI: 1.020-1.142; p = 0.008) and a higher body mass index (BMI) (HR = 1.257, 95%CI: 1.016-1.556; p = 0.035) were associated with increased risk of CKD progression.
LN remained the most common SGD in our region, while focal segmental glomerulosclerosis was the third most common PGD. Risk factors for worse outcome included a higher BMI, lower eGFR, and higher IFTA.
肾小球疾病（GD）是慢性肾脏病（CKD）的重要病因。本研究旨在分析GD患者的社会人口统计学、临床和肾脏结局特征。
进行了一项1998年至2023年的回顾性队列研究。参与者为年龄≥18岁、诊断为GD并在巴西一家大学医院接受治疗的患者。分析了社会人口统计学、临床、组织病理学和肾脏变量。对最常见的组织病理学诊断进行了比较分析。肾脏生存率是结局变量。
我们评估了417例患者，其中57.3%为女性，69.8%为白人。平均年龄为41.7±14.4岁。原发性肾小球疾病（PGD）占51.1%，77.5%的患者接受了肾活检。最常见的PGD是膜性肾病（26.3%），而在继发性肾小球疾病（SGD）中，狼疮性肾炎（LN）最常见（51.9%）。微小病变病与更好的肾脏生存率相关，而膜增生性肾小球肾炎的结局最差（p=0.001）。关于CKD进展，较高的初始估计肾小球滤过率（eGFR）具有保护作用（HR=0.956，95%CI：0.920-0.994；p=0.023），而存在间质纤维化/肾小管萎缩（IFTA）（HR=1.079，95%CI：1.020-1.142；p=0.008）和较高的体重指数（BMI）（HR=1.257，95%CI：1.016-1.556；p=0.035）与CKD进展风险增加相关。
LN仍然是我们地区最常见的SGD，而局灶节段性肾小球硬化是第三常见的PGD。预后较差的危险因素包括较高的BMI、较低的eGFR和较高的IFTA。
