Turkish Journal of Nephrology
Original Article

Effects of the Clinical and Biochemical Features of Patients with Treatment-Resistant Primary Nephrotic Syndrome on Renal Survival


İstanbul Medeniyet Üniversitesi, Göztepe Eğitim ve Araştırma Hastanesi, Nefroloji Bölümü, İstanbul, Türkiye


İstanbul Medeniyet Üniversitesi, Göztepe Eğitim ve Araştırma Hastanesi, Patoloji Bölümü, İstanbul, Türkiye

Turkish J Nephrol 2017; 26: 79-85
DOI: 10.5262/tndt.2017.1001.13
Read: 450 Downloads: 226 Published: 31 January 2019

OBJECTIVE: Nephrotic syndrome (NS) is commonly associated with progression of chronic kidney disease (CKD). Resistance to treatment is an important problem that is a poor prognostic factor for progression of CKD. Herein, we aimed to investigate the effects of clinical and biochemical parameters on renal survival in patients with treatment-resistant primary NS.

MATERIAL and METHODS: A total of 1305 NS cases who were followed were evaluated. Fifty primary NS patients (M/F: 32/18, mean age: 50±16) who had persistent proteinuria>3.5g/day despite treatment were included.

RESULTS: NS etiologies were as follows: membranous nephropathy (MN), 19 (38%); focal segmental glomerulosclerosis (FSGS), 16 (32%); IgA nephropathy (IgAN), 8 (16%) and membranoproliferative glomerulonephritis (MPGN), 7 (14%). Baseline GFR values were significantly lower in patients with IgAN [37(23-57) mL/min]. Annual rate of decline in GFR levels (∆GFR/year) was not different between the groups. Proteinuria was significantly associated with ∆GFR/year in patients with FSGS (r=-0.51, p=0.04). Baseline C-reactive-protein (CRP) levels were found to be correlated with ∆GFR/year in the MPGN group (r=-0.75,p=0.04). Smoking, hyperlipidemia and treatment had no effect on ΔGFR/years.

CONCLUSION: MN was the most frequent etiological factor in treatment-resistant primary NS. ∆GFR/year was similar in different types of glomerulonephritis. Treatment had no effect on renal survival. Proteinuria in FSGS and CRP in MPGN may predict progression of CKD. 

EISSN 2667-4440