Adult-onset minimal-change nephropathy has been associated with a slower response to corticosteroids and a less benign prognosis when compared to children.
However, there are few long-term outcome data reported.
We have reviewed retrospectively 51 idiopathic adult-onset minimal-change nephropathy patients investigated and treated at a single centre.
Male to female ratio was 1 : 1.4, mean age at diagnosis was 37 years, and average length of follow-up was 14.1 years.
Significant comorbidity was identified in 33%. A raised serum creatinine was found in 55% but returned to normal almost invariably upon remission.
At presentation, hypertension was found in 47% of patients, microscopic haematuria in 33%, hypercholesterolaemia and hypertriglyceridaemia in 96%, and hyperuricaemia in 42%. Remission (complete or partial) was achieved by 46,70 and 92% within 4,8 and 21 weeks respectively, in patients treated with steroids ; steroid resistance was encountered in 8%. The time to remission was positively correlated with age (P=0.002) and initial albumin level (P=0.005), and negatively correlated to the number of subsequent relapses (P=0.029) ; 33% of patients had a spontaneous remission at some time during the disease course.
Patients with multiple relapses were treated with cyclophosphamide and 63% of them had remained in remission after 5 years.
Hypertension was present in 25% of patients after an average interval of 11 years. (...)
Mots-clés Pascal : Néphropathie lésion glomérulaire minime, Age apparition, Adulte, Homme, Evolution, Long terme, Réponse, Traitement, Chimiothérapie, Corticostéroïde, Etude statistique, Appareil urinaire pathologie, Rein pathologie, Néphropathie glomérulaire
Mots-clés Pascal anglais : Minimal change nephrotic syndrome, Age of onset, Adult, Human, Evolution, Long term, Response, Treatment, Chemotherapy, Corticosteroid, Statistical study, Urinary system disease, Kidney disease, Glomerulonephritis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0015808
Code Inist : 002B14A01. Création : 21/05/1997.