Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa

 

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dc.contributor.author Okpechi, Ikechi G en_ZA
dc.contributor.author Dlamini, Thandiwe A L en_ZA
dc.contributor.author Duffield, Maureen en_ZA
dc.contributor.author Rayner, Brian L en_ZA
dc.contributor.author Moturi, George en_ZA
dc.contributor.author Swanepoel, Charles R en_ZA
dc.date.accessioned 2015-12-28T06:44:56Z
dc.date.available 2015-12-28T06:44:56Z
dc.date.issued 2014 en_ZA
dc.identifier.citation Okpechi, I. G., Dlamini, T. A., Duffield, M., Rayner, B. L., Moturi, G., & Swanepoel, C. R. (2013). Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa. PloS one, 9(11), e113302-e113302. doi:10.1371/journal.pone.0113302 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16015
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0113302
dc.description.abstract Background and Aim Mesangiocapillary glomerulonephritis (MCGN) is a common cause of chronic kidney disease in developing countries. Data on the renal outcome of patients with idiopathic MCGN is limited. The aim of this study is to investigate the outcome of patients with idiopathic MCGN presenting to the Groote Schuur Hospital (GSH) Renal Unit in Cape Town. Materials and METHODS: A retrospective study of patients with idiopathic MCGN followed up at our clinic. Seventy-nine patients with no identifiable cause of MCGN were included for analysis. A composite renal outcome of persistent doubling of serum creatinine or end stage renal disease (ESRD) was used. Kaplan Meier survival and Cox regression analysis were used to assess survival and identify factors predicting the outcome. RESULTS: The mean age at biopsy was 33.9±13.6 years and 41.8% were black. Mean duration of follow up was 13.5±18.8 months. Twenty-three patients (34.2%) reached the composite endpoint. Overall, median renal survival was 38.7±11.7 months (95% CI 15.7-61.8) with 2-year and 5-year renal survival of 61% and 40.3% respectively. No significant difference was found for renal survival between males and females, treatment or non-treatment with immunosuppression, presence or absence of crescents or histological type of MCGN (p>0.05). On univariate Cox-regression analysis, factors found to be associated with the outcome were the estimated glomerular filtration rate at biopsy (OR 0.97 [95%CI: 0.95-0.99], p<0.0001), black race (OR 3.03 [95%CI: 1.27-7.21], p = 0.012) and presence of interstitial fibrosis in the biopsy (OR 2.64 [95%CI: 1.07-6.48], p = 0.034). Age, systolic blood pressure and attaining complete or partial remission approached significant values with the endpoint. CONCLUSIONS: The outcome of idiopathic MCGN in Cape Town is poor and requires further prospective studies to improve our understanding of this common disease. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Biopsy en_ZA
dc.subject.other Fibrosis en_ZA
dc.subject.other Histology en_ZA
dc.subject.other Complement system en_ZA
dc.subject.other Blood pressure en_ZA
dc.subject.other Creatinine en_ZA
dc.subject.other Proteinuria en_ZA
dc.subject.other Glomeruli en_ZA
dc.title Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2014 Okpechi et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Nephrology and Hypertension en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Okpechi, I. G., Dlamini, T. A. L., Duffield, M., Rayner, B. L., Moturi, G., & Swanepoel, C. R. (2014). Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/16015 en_ZA
dc.identifier.chicagocitation Okpechi, Ikechi G, Thandiwe A L Dlamini, Maureen Duffield, Brian L Rayner, George Moturi, and Charles R Swanepoel "Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/16015 en_ZA
dc.identifier.vancouvercitation Okpechi IG, Dlamini TAL, Duffield M, Rayner BL, Moturi G, Swanepoel CR. Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa. PLoS One. 2014; http://hdl.handle.net/11427/16015. en_ZA
dc.identifier.ris TY - Journal Article AU - Okpechi, Ikechi G AU - Dlamini, Thandiwe A L AU - Duffield, Maureen AU - Rayner, Brian L AU - Moturi, George AU - Swanepoel, Charles R AB - Background and Aim Mesangiocapillary glomerulonephritis (MCGN) is a common cause of chronic kidney disease in developing countries. Data on the renal outcome of patients with idiopathic MCGN is limited. The aim of this study is to investigate the outcome of patients with idiopathic MCGN presenting to the Groote Schuur Hospital (GSH) Renal Unit in Cape Town. Materials and METHODS: A retrospective study of patients with idiopathic MCGN followed up at our clinic. Seventy-nine patients with no identifiable cause of MCGN were included for analysis. A composite renal outcome of persistent doubling of serum creatinine or end stage renal disease (ESRD) was used. Kaplan Meier survival and Cox regression analysis were used to assess survival and identify factors predicting the outcome. RESULTS: The mean age at biopsy was 33.9±13.6 years and 41.8% were black. Mean duration of follow up was 13.5±18.8 months. Twenty-three patients (34.2%) reached the composite endpoint. Overall, median renal survival was 38.7±11.7 months (95% CI 15.7-61.8) with 2-year and 5-year renal survival of 61% and 40.3% respectively. No significant difference was found for renal survival between males and females, treatment or non-treatment with immunosuppression, presence or absence of crescents or histological type of MCGN (p>0.05). On univariate Cox-regression analysis, factors found to be associated with the outcome were the estimated glomerular filtration rate at biopsy (OR 0.97 [95%CI: 0.95-0.99], p<0.0001), black race (OR 3.03 [95%CI: 1.27-7.21], p = 0.012) and presence of interstitial fibrosis in the biopsy (OR 2.64 [95%CI: 1.07-6.48], p = 0.034). Age, systolic blood pressure and attaining complete or partial remission approached significant values with the endpoint. CONCLUSIONS: The outcome of idiopathic MCGN in Cape Town is poor and requires further prospective studies to improve our understanding of this common disease. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0113302 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa TI - Outcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa UR - http://hdl.handle.net/11427/16015 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.