Long-term outcome of adult-onset minimal-change nephropathy.

Abstract

BACKGROUND:

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.

METHODS:

We have reviewed retrospectively 51 idiopathic adult-onset minimal-change nephropathy patients investigated and treated at a single centre.

RESULTS:

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. At the time of the final follow-up, only three patients had a raised creatinine and all but three patients were in complete remission.

CONCLUSIONS:

Adult-onset minimal-change nephropathy shares the same good long-term outcome as the childhood counterpart, with sustained remission and preserved renal function.

• Authors: S K Mak, C D Short, N P Mallick
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 11 Issue 11 Pg. 2192-201 (Nov 1996) ISSN: 0931-0509 [Print] England
• PMID: 8941578 (Publication Type: Journal Article)

Chemical References

• Steroids

Topics

• Adolescent
• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Nephrosis, Lipoid (drug therapy, physiopathology)
• Retrospective Studies
• Steroids (therapeutic use)
• Treatment Outcome