DOI: https://doi.org/10.22263/2312-4156.2020.4.30
Vykhrestsenka L.R.1, Schastlivenko A.I.1, Prakoshyna N.R.1, Bondarаva L.I.1, Klepikova T.G.2, Zhalnerouskaya K.E.2
Clinicomorphologic options of primary chronic glomerulonephritis in patients of the nephrological department of Vitebsk Regional Clinical Hospital
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2020;19(4):30-39.
Abstract.
Objectives. To analyze the conformity of clinical and laboratory parameters of primary chronic glomerulonephritis (CGN) to specific morphological forms of this disease.
Material and methods. A retrospective cross-sectional continuous-flow analysis of medical cards of 100 patients aged 18-65 years with a morphologically confirmed diagnosis of CGN made for the first time was carried out. Patients were divided into 2 groups: the first group included 74 patients with proliferative forms of CGN (extracapillary glomerulonephritis with «half-moon» (n=1), mesangioproliferative glomerulonephritis (n=68), including IgA-nephropathy (n=42), membrane proliferative (mesangiocapillary) glomerulonephritis (n=5); the second group consisted of 26 patients with non-proliferative forms of CGN (focal segmental glomerulosclerosis (n=15), disease of minimal changes (n=6), membranous nephropathy (n=5)). All patients underwent a comprehensive clinical and laboratory examination, ultrasound kidney investigation.
Results. It has been found that the most common proliferative morphological form of CGN was represented by mesangioproliferative glomerulonephritis (91.8%; 68/74), including IgA-nephropathy (56.7%; 42/74); and non-proliferative morphological form of CGN – by focal segmental glomerulosclerosis (57.7%; 15/26). A higher level of hematuria (p=0.003) was observed in proliferative forms of CGN, while in non-proliferative CGN higher levels of body mass index (p=0.03), total cholesterol (p=0.001) and triglycerides (p<0.001), proteinuria (p<0.001), lower levels of total blood serum protein (p<0.001) were observed. The clinical picture of proliferative CGN in 81.1% (63/74) of cases was represented by hematuric, latent and hypertensive variants; and in non-proliferative forms in 65.4% (17/26) of cases – by nephrotic and mixed variants.
Conclusions. The clinical picture of primary CGN may be similar in various morphological forms of the disease, which dictates the need for timely nephrobiopsy as an indispensable method of accurate diagnosis, the selection of the proper treatment and prognostication of disease development.
Key words: risk factors, primary chronic glomerulonephritis, nephrobiopsy, morphological forms.
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Information about authors:
Vykhrestsenka L.R. – Doctor of Medical Sciences, professor, head of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University;
Schastlivenko A.I. – Candidate of Medical Sciences, associate professor of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University;
Prakoshyna N.R. – Candidate of Medical Sciences, associate professor of the Chair of General and Clinical Pharmacology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
Bondarаva L.I. – lecturer of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University;
Klepikova T.G. – head of the nephrological department, Vitebsk Regional Clinical Hospital;
Zhalnerouskaya K.E. – doctor intern, Vitebsk Regional Clinical Hospital.
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, General Practitioner Chair with the course of Outpatient Therapy. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Andrei I. Schastlivenko.
