Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

Fernanda Payan Schober, Meghan A. Jobson, Caroline J. Poulton, Harsharan K. Singh, Volker Nickeleit, Ronald J. Falk, J. Charles Jennette, Patrick H. Nachman, William F.Pendergraft Iii

Research output: Contribution to journalArticle

Abstract

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

LanguageEnglish (US)
Pages248-256
Number of pages9
JournalAmerican Journal of Nephrology
Volume45
Issue number3
DOIs
StatePublished - Mar 1 2017

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Glomerulonephritis
Population
Hepacivirus
Autoimmune Diseases
Comorbidity
Hematuria
Virus Diseases
Infection
Proteinuria
Signs and Symptoms
Chronic Kidney Failure
Renal Insufficiency
Renal Dialysis
Neoplasms
Electron Microscopy
Demography
Databases
Kidney

Keywords

  • Black or African American
  • Fibrillary glomerulonephritis
  • Hepatitis C

ASJC Scopus subject areas

  • Nephrology

Cite this

Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis. / Schober, Fernanda Payan; Jobson, Meghan A.; Poulton, Caroline J.; Singh, Harsharan K.; Nickeleit, Volker; Falk, Ronald J.; Charles Jennette, J.; Nachman, Patrick H.; Iii, William F.Pendergraft.

In: American Journal of Nephrology, Vol. 45, No. 3, 01.03.2017, p. 248-256.

Research output: Contribution to journalArticle

Schober, FP, Jobson, MA, Poulton, CJ, Singh, HK, Nickeleit, V, Falk, RJ, Charles Jennette, J, Nachman, PH & Iii, WFP 2017, 'Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis' American Journal of Nephrology, vol 45, no. 3, pp. 248-256. DOI: 10.1159/000455390
Schober, Fernanda Payan ; Jobson, Meghan A. ; Poulton, Caroline J. ; Singh, Harsharan K. ; Nickeleit, Volker ; Falk, Ronald J. ; Charles Jennette, J. ; Nachman, Patrick H. ; Iii, William F.Pendergraft. / Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis. In: American Journal of Nephrology. 2017 ; Vol. 45, No. 3. pp. 248-256
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