Respuesta a la farmacoterapia en pacientes con glomerulonefritis membranoproliferativa en una clínica de Barranquilla, Colombia. 2007-2014
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Fecha
2018-07
Autores
Aroca-Martínez, Gustavo
González-Torres, Henry Joseth
Domínguez-Vargas, Alex
Fontalvo-Pastorizo, Jossie
Silva-Díaz, Diana
Cadena-Bonfanti, Andrés
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Universidad Nacional de Colombia
Resumen
Introducción. La glomerulonefritis membranoproliferativa (GnMP)
es un patrón de lesión glomerular hipercelular mesangial con
adelgazamiento de la membrana basal glomerular y proliferación
endocapilar que está mediado por las inmunoglobulinas o el sistema
del complemento en el mesangio y endotelio capilar.
Objetivo. Evaluar la respuesta a la farmacoterapia en pacientes
diagnosticados con GnMP en una clínica de Barranquilla entre los
años 2007 y 2014.
Materiales y métodos. Estudio de cohorte retrospectivo en el que se
evaluaron 58 pacientes con diagnóstico de GnMP por biopsia renal,
quienes se clasificaron como respondedores y no respondedores.
Se realizó una evaluación de tratamiento estándar según tipo de
GnMP: mediado por complemento y mediado por inmunocomplejos
e inmunofluorescencia negativa a los 6 y 12 meses de tratamiento.
Resultados. La edad promedio de los participantes fue de 35±13 años.
De 58 pacientes, 52% eran mujeres, 63% desarrolló enfermedad renal
crónica (ERC) al año de evaluación, 25.8% logró remisión (22.4%
completa y 3.4% parcial) y 74.2% no logró entrar en remisión.
Conclusión. La GnMP es una causa importante de ERC entre la
población estudiada. La respuesta al tratamiento inmunosupresor no
demostró beneficios estadísticamente significativos, independiente
del tipo de GnMP.
Introduction: Membranoproliferative glomerulonephritis (MPGN) is a pattern of mesangial hypercellular glomerular lesion with thinning of the glomerular basement membrane and endocapillary proliferation, mediated by immunoglobulin and the complement system of the mesangium and capillary endothelium. Objective: To assess the response to pharmacotherapy in patients diagnosed with MPGN in a hospital of Barranquilla between 2007 and 2014. Materials and methods: Retrospective cohort study in which 58 patients diagnosed with MPGN by renal biopsy were assessed and classified as responsive and non-responsive. A standard treatment assessment was performed according to the type of MPGN: mediated by the complement system, mediated by immunocomplexes, and negative immunofluorescence at 6 and 12 months of treatment. Results: The average age of the participants was 35±13 years. Of 58 patients, 52% were female, 63% developed chronic kidney disease (CKD) one year after the assessment, 25.8% achieved remission (22.4% complete and 3.4% partial) and 74.2% failed to enter remission. Conclusion: MPGN is one of the most important causes of CKD among the studied population. Response to immunosuppressant treatment showed no statistically significant benefits, regardless of the type of MPGN.
Introduction: Membranoproliferative glomerulonephritis (MPGN) is a pattern of mesangial hypercellular glomerular lesion with thinning of the glomerular basement membrane and endocapillary proliferation, mediated by immunoglobulin and the complement system of the mesangium and capillary endothelium. Objective: To assess the response to pharmacotherapy in patients diagnosed with MPGN in a hospital of Barranquilla between 2007 and 2014. Materials and methods: Retrospective cohort study in which 58 patients diagnosed with MPGN by renal biopsy were assessed and classified as responsive and non-responsive. A standard treatment assessment was performed according to the type of MPGN: mediated by the complement system, mediated by immunocomplexes, and negative immunofluorescence at 6 and 12 months of treatment. Results: The average age of the participants was 35±13 years. Of 58 patients, 52% were female, 63% developed chronic kidney disease (CKD) one year after the assessment, 25.8% achieved remission (22.4% complete and 3.4% partial) and 74.2% failed to enter remission. Conclusion: MPGN is one of the most important causes of CKD among the studied population. Response to immunosuppressant treatment showed no statistically significant benefits, regardless of the type of MPGN.
Descripción
Palabras clave
Glomerulonefritis, Glomerulonefritis membranoproliferativa, Síndrome nefrótico, Inmunosupresión (DeCS), Glomerulonephritis, Membranoproliferative Glomerulonephritis, Nephrotic Syndrome, Immunosuppression (MeSH)