Clinical and renal biopsy findings predicting outcome in renal thrombotic microangiopathy: a large cohort study from a single institute in China

ScientificWorldJournal. 2014;2014:680502. doi: 10.1155/2014/680502. Epub 2014 Aug 11.

Abstract

Objective: The current study aimed to investigate the spectrum of etiologies and associated disorders of renal biopsy-proven thrombotic microangiopathy (TMA) patients.

Methods: The clinical, laboratory, and renal histopathological data of patients with renal TMA from 2000 to 2012 in our institute were collected and reviewed.

Results: One hundred and nine TMA patients were enrolled in this study. The mean age was 34.0 ± 11.1 years. Seventy patients (64.2%) were male and thirty-nine patients (35.8%) were female. There were eight patients (7.3%) with hemolytic uremic syndrome (HUS). Sixty-one patients (56.0%) were secondary to malignant hypertension. Fourteen patients (12.8%) were pregnancy-associated TMA. Other associated disorders included 17 patients with connective tissue disorders, 2 patients with hematopoietic stem cell transplantation, 4 patients with Castleman's disease, 1 patient with cryoglobulinemia, and 2 patients with glomerulopathy. During followup, 8 patients died due to severe infection, 17 patients had doubling of serum creatinine, and 44 had end-stage renal disease. In multivariate analysis, male, elevated serum creatinine, and decreased hemoglobin were independently associated with poor renal outcomes.

Conclusions: Renal TMA changes consisted of different disorders with various etiologies. aHUS, pregnancy-associated TMA, and malignant hypertension accounted for the majority of patients in our cohort.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney / pathology*
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Patient Outcome Assessment
  • Plasma Exchange
  • Prognosis
  • Retrospective Studies
  • Thrombotic Microangiopathies / diagnosis*
  • Thrombotic Microangiopathies / etiology*
  • Thrombotic Microangiopathies / mortality
  • Thrombotic Microangiopathies / therapy
  • Treatment Outcome
  • Young Adult

Substances

  • Immunosuppressive Agents