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. 2016 Jan 22;11(1):e0147387.
doi: 10.1371/journal.pone.0147387. eCollection 2016.

Glomerular Immune Deposits Are Predictive of Poor Long-Term Outcome in Patients with Adult Biopsy-Proven Minimal Change Disease: A Cohort Study in Korea

Sung Woo Lee  1   2 , Mi-Yeon Yu  2 , Seon Ha Baek  2 , Shin-Young Ahn  1   2 , Sejoong Kim  2 , Ki Young Na  2   3 , Dong-Wan Chae  2   3 , Ho Jun Chin  1   2   3
Affiliations

Glomerular Immune Deposits Are Predictive of Poor Long-Term Outcome in Patients with Adult Biopsy-Proven Minimal Change Disease: A Cohort Study in Korea

Sung Woo Lee et al. PLoS One. .

Abstract

Background and objectives: There has been little published information on risk factors for poor long-term outcome in adult biopsy-proven minimal change disease (MCD).

Methods: Data from sixty-three adult, biopsy-proven primary MCD patients treated at a tertiary university hospital between 2003 and 2013 were analyzed. Baseline clinical and pathologic factors were assessed for the associations with composite outcome of creatinine doubling, end stage renal disease, or all-cause mortality.

Results: During a median (interquartile) 5.0 (2.8-5.0) years, the composite outcome occurred in 11.1% (7/63) of patients. The rate of glomerular immune deposits was 23.8% (15/63). Patients with glomerular immune deposits showed a significantly lower urine protein creatinine ratio than those without deposits (P = 0.033). The rate of non-responders was significantly higher in patients with glomerular immune deposits than in those without deposits (P = 0.033). In patients with deposits, 26.7% (4/15) developed the composite outcome, while only 6.3% (3/48) developed the composite outcome among those without deposits (P = 0.049). In multivariate Cox proportional hazards regression analysis, the presence of glomerular immune deposits was the only factor associated with development of the composite outcome (hazard ratio: 2.310, 95% confidence interval: 1.031-98.579, P = 0.047).

Conclusion: Glomerular immune deposits were associated with increased risk of a composite outcome in adult MCD patients. The higher rate of non-responders in patients with deposits might be related to the poor outcome. Future study is needed.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier survival curve according to the status of glomerular immune deposits.
Mean (95% CI) survival of negative and positive glomerular immune deposit groups were 4.8 (4.6–5.0) years and 4.1 (3.2–5.0) years, respectively.
Fig 2
Fig 2. Typical results of immunofluorescence (IF) staining.
A shows a negative IF result, B shows a positive result for the linear peripheral pattern and C shows a positive result for the granular mesangial pattern.
Fig 3
Fig 3. Intensity of deposits in immunofluorescence stain.
GID, glomerular immune deposits.
Fig 4
Fig 4. Clinical and immunofluorescence findings in patients with glomerular immune deposits.
* demonstrates patients with < 3.0 g/g of urine protein creatinine ratio. EDD, electron dense deposit.
See this image and copyright information in PMC

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