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

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dc.contributor.authorOkpechi, Ikechi Gen_ZA
dc.contributor.authorDlamini, Thandiwe A Len_ZA
dc.contributor.authorDuffield, Maureenen_ZA
dc.contributor.authorRayner, Brian Len_ZA
dc.contributor.authorMoturi, Georgeen_ZA
dc.contributor.authorSwanepoel, Charles Ren_ZA
dc.date.accessioned2015-12-28T06:44:56Z
dc.date.available2015-12-28T06:44:56Z
dc.date.issued2014en_ZA
dc.description.abstractBackground 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.identifier.apacitationOkpechi, 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/11427/16015en_ZA
dc.identifier.chicagocitationOkpechi, 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/11427/16015en_ZA
dc.identifier.citationOkpechi, 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.0113302en_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
dc.identifier.urihttp://hdl.handle.net/11427/16015
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0113302
dc.identifier.vancouvercitationOkpechi 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.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Nephrology and Hypertensionen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2014 Okpechi et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherBiopsyen_ZA
dc.subject.otherFibrosisen_ZA
dc.subject.otherHistologyen_ZA
dc.subject.otherComplement systemen_ZA
dc.subject.otherBlood pressureen_ZA
dc.subject.otherCreatinineen_ZA
dc.subject.otherProteinuriaen_ZA
dc.subject.otherGlomerulien_ZA
dc.titleOutcome of patients with primary immune-complex type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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