Nephrotic syndrome with focal segmental glomerular lesions unclassified by Columbia classification; Pathology and clinical implication
The Columbia classification is widely used for diagnosis of focal segmental glomerulosclerosis (FSGS). In practice, we occasionally encounter segmental glomerular lesions unclassified as Columbia classification. We analyzed the clinical implication of unclassified segmental lesions comparing with Co...
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| creator | Ozeki, Takaya Nagata, Michio Katsuno, Takayuki Inagaki, Koji Goto, Kazunori Kato, Sawako Yasuda, Yoshinari Tsuboi, Naotake Maruyama, Shoichi |
| description | The Columbia classification is widely used for diagnosis of focal segmental glomerulosclerosis (FSGS). In practice, we occasionally encounter segmental glomerular lesions unclassified as Columbia classification. We analyzed the clinical implication of unclassified segmental lesions comparing with Columbia-classified FSGS.
A retrospective cohort study from 13 local hospitals in Japan. From 172 biopsy cases diagnosed with FSGS or minimal change disease (MCD)/FSGS spectrum with unclassified segmental lesions, adult patients with nephrotic syndrome who received immunosuppressive therapies were included. The cases are classified by pathology, i.e., typical FSGS lesions sufficiently classified into subgroups of Columbia classification: collapsing (COL), tip (TIP), cellular (CEL), perihilar (PH), and not otherwise specified (NOS), and unclassified by the Columbia classification into three subgroups: "endothelial damage,"; "simple attachment,"; and "minor cellular lesion,". The response to immunosuppressive treatment and 30% decline of eGFR were compared.
Among 48 eligible cases, all were Japanese, 34 were typical FSGS; 13 TIP, 15 CEL, 6 NOS, and no COL or PH cases. Fourteen were unclassified cases: endothelial damage (n = 6), simple attachment (n = 5), and minor cellular lesion (n = 3). The median age of overall patients was 60 years old and the median of eGFR and urinary protein creatinine ratio was 51.5 mL/min/1.73m2 and 7.35, respectively. They received similar therapeutic regimen. Kaplan-Meier analysis revealed no significant difference in treatment response between typical FSGS and unclassified cases. Evaluating among the subgroups, endothelial damage, simple attachment and minor cellular lesion showed similar treatment response to TIP or CEL. No significant difference was also observed in the 30% decline of eGFR.
Japanese adult patients with nephrotic syndrome showing unclassified segmental lesions as Columbia classification may be equivalent clinical impact as Columbia classification of FSGS. |
| doi_str_mv | 10.1371/journal.pone.0244677 |
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A retrospective cohort study from 13 local hospitals in Japan. From 172 biopsy cases diagnosed with FSGS or minimal change disease (MCD)/FSGS spectrum with unclassified segmental lesions, adult patients with nephrotic syndrome who received immunosuppressive therapies were included. The cases are classified by pathology, i.e., typical FSGS lesions sufficiently classified into subgroups of Columbia classification: collapsing (COL), tip (TIP), cellular (CEL), perihilar (PH), and not otherwise specified (NOS), and unclassified by the Columbia classification into three subgroups: "endothelial damage,"; "simple attachment,"; and "minor cellular lesion,". The response to immunosuppressive treatment and 30% decline of eGFR were compared.
Among 48 eligible cases, all were Japanese, 34 were typical FSGS; 13 TIP, 15 CEL, 6 NOS, and no COL or PH cases. Fourteen were unclassified cases: endothelial damage (n = 6), simple attachment (n = 5), and minor cellular lesion (n = 3). The median age of overall patients was 60 years old and the median of eGFR and urinary protein creatinine ratio was 51.5 mL/min/1.73m2 and 7.35, respectively. They received similar therapeutic regimen. Kaplan-Meier analysis revealed no significant difference in treatment response between typical FSGS and unclassified cases. Evaluating among the subgroups, endothelial damage, simple attachment and minor cellular lesion showed similar treatment response to TIP or CEL. No significant difference was also observed in the 30% decline of eGFR.
Japanese adult patients with nephrotic syndrome showing unclassified segmental lesions as Columbia classification may be equivalent clinical impact as Columbia classification of FSGS.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0244677</identifier><identifier>PMID: 33400710</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Attachment ; Biology and Life Sciences ; Biopsy ; Care and treatment ; Classification ; Clinical outcomes ; Collapse ; Creatinine ; Damage ; Development and progression ; Diagnosis ; Epidermal growth factor receptors ; Female ; Glomerulonephritis ; Health services ; HIV ; Hospitals ; Human immunodeficiency virus ; Humans ; Immunosuppressive agents ; Immunosuppressive Agents - therapeutic use ; Japan - epidemiology ; Kidney diseases ; Kidney Glomerulus - drug effects ; Kidney Glomerulus - pathology ; Lesions ; Male ; Medicine ; Medicine and Health Sciences ; Microscopy ; Middle Aged ; Morphology ; Mutation ; Nephrology ; Nephrotic syndrome ; Nephrotic Syndrome - diagnosis ; Nephrotic Syndrome - drug therapy ; Nephrotic Syndrome - epidemiology ; Nephrotic Syndrome - pathology ; Pathology ; Patients ; Research and Analysis Methods ; Retrospective Studies ; Stains & staining ; Subgroups ; Treatment Outcome ; University graduates</subject><ispartof>PloS one, 2021-01, Vol.16 (1), p.e0244677-e0244677</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Ozeki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Ozeki et al 2021 Ozeki et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-420e03575f70b89063362da9e0f6af6e8ac0df516da4b06f482406938b8792153</citedby><cites>FETCH-LOGICAL-c692t-420e03575f70b89063362da9e0f6af6e8ac0df516da4b06f482406938b8792153</cites><orcidid>0000-0002-8858-632X ; 0000-0002-1839-1180</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785116/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785116/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33400710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Remuzzi, Giuseppe</contributor><creatorcontrib>Ozeki, Takaya</creatorcontrib><creatorcontrib>Nagata, Michio</creatorcontrib><creatorcontrib>Katsuno, Takayuki</creatorcontrib><creatorcontrib>Inagaki, Koji</creatorcontrib><creatorcontrib>Goto, Kazunori</creatorcontrib><creatorcontrib>Kato, Sawako</creatorcontrib><creatorcontrib>Yasuda, Yoshinari</creatorcontrib><creatorcontrib>Tsuboi, Naotake</creatorcontrib><creatorcontrib>Maruyama, Shoichi</creatorcontrib><title>Nephrotic syndrome with focal segmental glomerular lesions unclassified by Columbia classification; Pathology and clinical implication</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The Columbia classification is widely used for diagnosis of focal segmental glomerulosclerosis (FSGS). In practice, we occasionally encounter segmental glomerular lesions unclassified as Columbia classification. We analyzed the clinical implication of unclassified segmental lesions comparing with Columbia-classified FSGS.
A retrospective cohort study from 13 local hospitals in Japan. From 172 biopsy cases diagnosed with FSGS or minimal change disease (MCD)/FSGS spectrum with unclassified segmental lesions, adult patients with nephrotic syndrome who received immunosuppressive therapies were included. The cases are classified by pathology, i.e., typical FSGS lesions sufficiently classified into subgroups of Columbia classification: collapsing (COL), tip (TIP), cellular (CEL), perihilar (PH), and not otherwise specified (NOS), and unclassified by the Columbia classification into three subgroups: "endothelial damage,"; "simple attachment,"; and "minor cellular lesion,". The response to immunosuppressive treatment and 30% decline of eGFR were compared.
Among 48 eligible cases, all were Japanese, 34 were typical FSGS; 13 TIP, 15 CEL, 6 NOS, and no COL or PH cases. Fourteen were unclassified cases: endothelial damage (n = 6), simple attachment (n = 5), and minor cellular lesion (n = 3). The median age of overall patients was 60 years old and the median of eGFR and urinary protein creatinine ratio was 51.5 mL/min/1.73m2 and 7.35, respectively. They received similar therapeutic regimen. Kaplan-Meier analysis revealed no significant difference in treatment response between typical FSGS and unclassified cases. Evaluating among the subgroups, endothelial damage, simple attachment and minor cellular lesion showed similar treatment response to TIP or CEL. No significant difference was also observed in the 30% decline of eGFR.
Japanese adult patients with nephrotic syndrome showing unclassified segmental lesions as Columbia classification may be equivalent clinical impact as Columbia classification of FSGS.</description><subject>Adult</subject><subject>Aged</subject><subject>Attachment</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Care and treatment</subject><subject>Classification</subject><subject>Clinical outcomes</subject><subject>Collapse</subject><subject>Creatinine</subject><subject>Damage</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>Health services</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Japan - epidemiology</subject><subject>Kidney diseases</subject><subject>Kidney Glomerulus - drug effects</subject><subject>Kidney Glomerulus - pathology</subject><subject>Lesions</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Microscopy</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Mutation</subject><subject>Nephrology</subject><subject>Nephrotic syndrome</subject><subject>Nephrotic Syndrome - diagnosis</subject><subject>Nephrotic Syndrome - drug therapy</subject><subject>Nephrotic Syndrome - epidemiology</subject><subject>Nephrotic Syndrome - pathology</subject><subject>Pathology</subject><subject>Patients</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Stains & staining</subject><subject>Subgroups</subject><subject>Treatment Outcome</subject><subject>University 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syndrome with focal segmental glomerular lesions unclassified by Columbia classification; Pathology and clinical implication</title><author>Ozeki, Takaya ; Nagata, Michio ; Katsuno, Takayuki ; Inagaki, Koji ; Goto, Kazunori ; Kato, Sawako ; Yasuda, Yoshinari ; Tsuboi, Naotake ; Maruyama, Shoichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-420e03575f70b89063362da9e0f6af6e8ac0df516da4b06f482406938b8792153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Attachment</topic><topic>Biology and Life Sciences</topic><topic>Biopsy</topic><topic>Care and treatment</topic><topic>Classification</topic><topic>Clinical outcomes</topic><topic>Collapse</topic><topic>Creatinine</topic><topic>Damage</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Epidermal growth factor 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One</addtitle><date>2021-01-05</date><risdate>2021</risdate><volume>16</volume><issue>1</issue><spage>e0244677</spage><epage>e0244677</epage><pages>e0244677-e0244677</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The Columbia classification is widely used for diagnosis of focal segmental glomerulosclerosis (FSGS). In practice, we occasionally encounter segmental glomerular lesions unclassified as Columbia classification. We analyzed the clinical implication of unclassified segmental lesions comparing with Columbia-classified FSGS.
A retrospective cohort study from 13 local hospitals in Japan. From 172 biopsy cases diagnosed with FSGS or minimal change disease (MCD)/FSGS spectrum with unclassified segmental lesions, adult patients with nephrotic syndrome who received immunosuppressive therapies were included. The cases are classified by pathology, i.e., typical FSGS lesions sufficiently classified into subgroups of Columbia classification: collapsing (COL), tip (TIP), cellular (CEL), perihilar (PH), and not otherwise specified (NOS), and unclassified by the Columbia classification into three subgroups: "endothelial damage,"; "simple attachment,"; and "minor cellular lesion,". The response to immunosuppressive treatment and 30% decline of eGFR were compared.
Among 48 eligible cases, all were Japanese, 34 were typical FSGS; 13 TIP, 15 CEL, 6 NOS, and no COL or PH cases. Fourteen were unclassified cases: endothelial damage (n = 6), simple attachment (n = 5), and minor cellular lesion (n = 3). The median age of overall patients was 60 years old and the median of eGFR and urinary protein creatinine ratio was 51.5 mL/min/1.73m2 and 7.35, respectively. They received similar therapeutic regimen. Kaplan-Meier analysis revealed no significant difference in treatment response between typical FSGS and unclassified cases. Evaluating among the subgroups, endothelial damage, simple attachment and minor cellular lesion showed similar treatment response to TIP or CEL. No significant difference was also observed in the 30% decline of eGFR.
Japanese adult patients with nephrotic syndrome showing unclassified segmental lesions as Columbia classification may be equivalent clinical impact as Columbia classification of FSGS.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33400710</pmid><doi>10.1371/journal.pone.0244677</doi><tpages>e0244677</tpages><orcidid>https://orcid.org/0000-0002-8858-632X</orcidid><orcidid>https://orcid.org/0000-0002-1839-1180</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2021-01, Vol.16 (1), p.e0244677-e0244677 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2475314847 |
| source | PubMed Central Free; MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Attachment Biology and Life Sciences Biopsy Care and treatment Classification Clinical outcomes Collapse Creatinine Damage Development and progression Diagnosis Epidermal growth factor receptors Female Glomerulonephritis Health services HIV Hospitals Human immunodeficiency virus Humans Immunosuppressive agents Immunosuppressive Agents - therapeutic use Japan - epidemiology Kidney diseases Kidney Glomerulus - drug effects Kidney Glomerulus - pathology Lesions Male Medicine Medicine and Health Sciences Microscopy Middle Aged Morphology Mutation Nephrology Nephrotic syndrome Nephrotic Syndrome - diagnosis Nephrotic Syndrome - drug therapy Nephrotic Syndrome - epidemiology Nephrotic Syndrome - pathology Pathology Patients Research and Analysis Methods Retrospective Studies Stains & staining Subgroups Treatment Outcome University graduates |
| title | Nephrotic syndrome with focal segmental glomerular lesions unclassified by Columbia classification; Pathology and clinical implication |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T11%3A56%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Nephrotic%20syndrome%20with%20focal%20segmental%20glomerular%20lesions%20unclassified%20by%20Columbia%20classification;%20Pathology%20and%20clinical%20implication&rft.jtitle=PloS%20one&rft.au=Ozeki,%20Takaya&rft.date=2021-01-05&rft.volume=16&rft.issue=1&rft.spage=e0244677&rft.epage=e0244677&rft.pages=e0244677-e0244677&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0244677&rft_dat=%3Cgale_plos_%3EA647526303%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2475314847&rft_id=info:pmid/33400710&rft_galeid=A647526303&rft_doaj_id=oai_doaj_org_article_4087ce9a9fa74221827a566a2bff1fbc&rfr_iscdi=true |