Elahi T, Ahmed S, Mubarak M. Short-term renal and patient outcomes of primary immunoglobulin-associated mesangiocapillary glomerulonephritis: Insights from a developing country. World J Nephrol 2024; 13(4): 98969 [DOI: 10.5527/wjn.v13.i4.98969]
Corresponding Author of This Article
Muhammed Mubarak, MD, Full Professor, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Pakistan. drmubaraksiut@yahoo.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Dec 25, 2024; 13(4): 98969 Published online Dec 25, 2024. doi: 10.5527/wjn.v13.i4.98969
Short-term renal and patient outcomes of primary immunoglobulin-associated mesangiocapillary glomerulonephritis: Insights from a developing country
Tabassum Elahi, Saima Ahmed, Muhammed Mubarak
Tabassum Elahi, Saima Ahmed, Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi 74200, Pakistan
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Pakistan
Author contributions: Elahi T performed the experiments, analyzed the data, wrote the manuscript with input from all authors; Ahmed S contributed to the interpretation of the results; Mubarak M supervised the project and critically revised and finalized the draft; Elahi T and Ahmed S designed the study; Elahi T and Mubarak M provided critical feedback and helped shape the research, analysis, and manuscript; All authors read and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Sindh Institute of Urology and Transplantation (Pakistan).
Informed consent statement: All study participants or their legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The dataset and related documents are available from the corresponding author at elahitabassum@gmail.com.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, MD, Full Professor, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Pakistan. drmubaraksiut@yahoo.com
Received: July 10, 2024 Revised: September 9, 2024 Accepted: September 19, 2024 Published online: December 25, 2024 Processing time: 119 Days and 23.7 Hours
Abstract
BACKGROUND
Primary immunoglobulin (Ig)-associated mesangiocapillary glomerulonephritis (Ig-MCGN) is an immune complex glomerulonephritis of unknown etiology. It is a common cause of chronic kidney disease in developing countries. There is limited data available on renal and patient outcomes of this disease from developing countries.
AIM
To determine the short-term renal and patient outcomes of adults with a tissue-confirmed diagnosis of primary Ig-MCGN at a single center in Pakistan.
METHODS
A retrospective cohort study of adult patients was conducted on biopsy-proven Ig-MCGN cases diagnosed between 1998 and 2019 at the Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Secondary causes were excluded. The primary endpoint was renal survival without end-stage kidney disease (ESKD) or mortality. The secondary endpoint was the rate of remission during the 2-year follow-up period. Survival curves were made with the use of Kaplan-Meier estimates.
RESULTS
A total of 163 patients were included in the study and their mean follow-up duration was 29.45 months ± 21.28 months. Among baseline characteristics, young age, lower estimated glomerular filtration rate, requirement of kidney replacement therapy, presence of crescents, and severity of interstitial fibrosis and tubular atrophy were found to have a significant association with renal outcomes. The renal outcomes were negatively correlated with the presence of hypertension, level of complements, and degree of proteinuria. In all, 63 (37.4%) patients were treated with steroids and 21 (13%) received combination therapy (cyclophosphamide with steroids). At 2 years, 124 (76.07%) patients were in complete remission or partial remission [56 (34.3%) and 68 (41.71%), respectively], while 32 (19.63%) patients progressed to ESKD and 7 (4.29%) patients died.
CONCLUSION
The outcomes of primary Ig-MCGN are guarded in Pakistan and require further prospective studies to improve our understanding of this relatively common disease so that more personalized treatment approaches can be developed.
Core Tip: Primary immunoglobulin (Ig)-associated mesangiocapillary glomerulonephritis (Ig-MCGN) is an immune complex glomerulonephritis of unknown etiology. It is a common cause of chronic kidney disease in developing countries. There is limited data available on renal and patient outcomes from developing countries. In this study, the outcomes of primary Ig-MCGN were guarded and require further prospective studies to improve the understanding of this relatively common disease so that more personalized treatment approaches can be developed.
