Letter to the Editor
Fibronectin glomerulopathy in a 88 year-old male with acute kidney injury on chronic kidney disease: A case report and a review of the literature
Glomerulopatía fibronectina en un anciano de 88 años de edad con lesión renal aguda en enfermedad renal crónica: reporte de un caso y revisión sistemática de la literatura
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Two case reports" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "96" "paginaFinal" => "98" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma humeral verdadero en relación con acceso vascular en paciente trasplantado renal: a propósito de 2 casos clínicos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1485 "Ancho" => 1447 "Tamanyo" => 208937 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Selective arteriography: (A) humeral artery with a maximum diameter of 6<span class="elsevierStyleHsp" style=""></span>cm. 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array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 1 => array:3 [ "nombre" => "Zheng" "apellidos" => "Wang" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 2 => array:3 [ "nombre" => "Wenming" "apellidos" => "Yuan" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Yanna" "apellidos" => "Dou" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Dong" "apellidos" => "Liu" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Jing" "apellidos" => "Xiao" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:4 [ "nombre" => "Zhanzheng" "apellidos" => "Zhao" "email" => array:2 [ 0 => "13938525666@139.com" 1 => "zhanzhengzhao@zzu.edu.cn" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "The Nephrology Center of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Zhengzhou University Institute of Nephrology, Zhengzhou, China" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Glomerulopatía fibronectina en un anciano de 88 años de edad con lesión renal aguda en enfermedad renal crónica: reporte de un caso y revisión sistemática de la literatura" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1690 "Ancho" => 3333 "Tamanyo" => 606885 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Fibronectin glomerulopathy (FGP) was first recognized through direct staining in 1992 by Mazzucco et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> It was regarded as a rare autosomal dominant disease that tends to happen in various age groups and affects both sexes. The clinical features of this disease were proteinuria, typically nephrotic range, microscopic hematuria, hypertension and a slow decline in renal function.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1–11</span></a> However, some patients progress to end-stage renal disease (ESRD) and dialysis has been reported.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5,12–14</span></a> Herein we reported a case of FGP that was diagnosed based on the classic ultrastructural features described above. This case was unique in that FGP presents in a male who was 88 years of age and has no known family history of FGP.</p><p id="par0010" class="elsevierStylePara elsevierViewall">An 88-year-old gentleman was admitted with anuria requiring dialysis for uremic encephalopathy and volume overload. He had an extensive past medical history including chronic renal failure (baseline Cr 200–240<span class="elsevierStyleHsp" style=""></span>μmol/L) one month ago, hypertension, obstructive sleep apnea, mild cognitive impairment, query previous congestive heart failure, diastolic dysfunction, COPD, macular degeneration, benign prostatic hypertrophy and an anemia that was being investigated as an outpatient. Baseline level of proteinuria was unknown. There was no family history of kidney disease.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Relevant initial blood work included a serum creatinine of 1148<span class="elsevierStyleHsp" style=""></span>μmol/L, urea 82.2<span class="elsevierStyleHsp" style=""></span>mmol/L and potassium 5.7<span class="elsevierStyleHsp" style=""></span>mmol/L. During his stay in hospital, a 24-h urine collection was done and only 100<span class="elsevierStyleHsp" style=""></span>mL of urine were collected with 100<span class="elsevierStyleHsp" style=""></span>mg of protein and a protein excretion of 1<span class="elsevierStyleHsp" style=""></span>g/L. The other results of blood examination are as follows: a normal ESR, C3 and C4 values, negative ANA, c-ANCA, p-ANCA, anti-GBM antibody, hepatitis B and C serology, renal ultrasound showed normal size of the kidney. The extranuclear antigen screen was negative except RNP. Immunofixation revealed a serum IgG M-protein with kappa light chain specificity. Bone marrow studies were unremarkable.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A renal biopsy was performed and light microscopy showed a lobular appearance with cellular mesangial nodules that were expanded by matrix. There was also prominent arteriolar fibrointimal hyperplasia and arteriolar hyalinosis. Congo red staining was negative for amyloid. Immunostaining was 2+ for C3 in a granular pattern in the glomerular capillary walls, however staining was negative for IgA, IgG, IgM, kappa, lambda, albumin, fibrin and C1. Electron microscopy showed prominent expansion of the mesangial and subendothelial regions with numerous randomly arranged fibrils seen under high power lens, measuring 10.7–16.8<span class="elsevierStyleHsp" style=""></span>nm in diameter. Polyclonal rabbit antibody (DAKO, A0245) was used in staining of fibronectin and there was positivity in the mesangium, mesangial nodules and capillary walls (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient received regular hemodialysis and other supportive treatment including anti-hypertension, improving anemia, and preventing renal osteopathy. Unfortunately, this patient died of heart attack half a year later.</p><p id="par0030" class="elsevierStylePara elsevierViewall">To our knowledge, most cases of FGP have presented and been diagnosed in patients under 65-year-old. As this patient was diagnosed with FGP at the age of 88, we reviewed the cases reported in literatures and attempted to explain how this patient's disease course fits within our understanding of FGP.</p><p id="par0035" class="elsevierStylePara elsevierViewall">A PubMed search using the terms “fibronectin glomerulopathy” yielded 16 articles reports in English of patients with biopsy and fibronectin staining proven FGP. This allowed us to compare the disease features of 64 patients, including the patient described in this paper (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). These patients received renal biopsy at the age of 3–88, which was a wide range. The majority of patients had proteinuria for more than 5 years before being diagnosed, which supported the idea that the onset of disease occurs at younger ages. Most of the reported cases were patients in European countries, and there were several cases reported in Asia in recent years.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">FGP is understood to present with nephrotic range proteinuria and we found 23 (35.9%) of the 64 cases that reported proteinuria were nephrotic range. 21(32.8%) patients had microhematuria at the time of biopsy. Slightly more than half of the cases had hypertension. There was no association between degree of proteinuria, microhematruia and hypertension. The degrees of renal impairment at the time of biopsy were variable. Most of them had slow decline in renal function. 22 (34.3%) patients’ serum creatinine was stable, and 24 (37.5%) patients progressed to ESRD or dead. What appears different was that our patient had severe renal impairment at the time of his diagnosis.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In general, the timing of disease seems to be the distinguishing feature of our patient. Our patient had a history of chronic kidney disease on the basis of hypertension, however he came to hospital with ESRD requiring dialysis and a renal biopsy led to the discovery of FGP. With the usual disease course of FGP being slowly progressive with proteinuria of several years’ duration, it is possible that our patient had FGP and hypertensive kidney disease for many years and that a third insult may have precipitated ESRD. In his case it may have been the concomitant pneumonia.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In conclusion, FGP is an autosomal dominant disease that has an indolent disease course after a typical presentation in adulthood. Here we reported a case of FGP diagnosed in an 88-year-old gentleman at the time of his progression to ESRD. This may suggest that he had an exceptionally long indolent course if the onset of disease was during middle age, or perhaps he had an atypically late onset of disease. Further studies are needed to characterize the disease course in FGP as well as the tendency of FGP to ESRD.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Yours sincerely,</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">These authors contributed equally to this work.</p>" "identificador" => "fn0005" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1690 "Ancho" => 3333 "Tamanyo" => 606885 ] ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">HTN: hypertension.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Bx: biopsy.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Note: If a particular piece of information was not available, the space is filled with “N/A”.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reporter \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No. \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Age at Bx \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Femal:male \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Hypertension \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Proteinuria (g/24<span class="elsevierStyleHsp" style=""></span>h) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Micro-hematuria \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Cr (μmol/l) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Time of last outcome \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Last renal outcome \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mazzucco et al. (1992)<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14, 33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2:0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 patients: nephrotic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53,141 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 patient: 4 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 patient: Cr was stable \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Strom et al. (1995)<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14–59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7:16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 patients: YES<br>8 patient: NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 patients: positive<br>(9 patients: nephritic) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 patients: positive<br>7 patients: negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45.8–137 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1–15 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 patients: Cr was stable<br>4 patients: dialysis<br>4 patients: transplant<br>4 patients: dead<br>1 patient: normal Cr, renal cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Assmann et al. (1995)<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19, 46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 patient: YES<br>1 patient: NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.8,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">76, 100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gemperle et al. (1996)<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20–46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3:6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 patients: YES<br>1 patient: NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 patients: positive<br>(1 patient: nephrotic) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6–21 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 patients: hemodalysis<br>2 patients: CAPD<br>3 patients: dead \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fujigaki et al. (1997)<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1:0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sato et al. (1998)<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1–2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Niimi et al. (2002)<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cr was stable \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Castelletti et al. (2008)<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12–59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1:7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 patients: YES<br>4 patient: NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 patients: positive<br>(4 patient: nephrotic) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 patients: positive<br>1 patients: negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><194.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2–23 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 patients: Cr was stable<br>2 patients: dialysis<br>1 patients: transplant<br>1 patients: dead<br>1 patient: normal Cr, renal cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yong et al. (2009)<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nephrotic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Brcic et al. (2010)<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cr was stable \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nadamuni et al. (2012)<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1:0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nephrotic range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Otsuka et al. (2012)<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.5<span class="elsevierStyleHsp" style=""></span>g/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.54 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ertoy et al. (2013)<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0:1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ishimoto et al. (2013)<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1:0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nephrotic range \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">101 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dialysis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yoshino et al. (2013)<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">YES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 yr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.54 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chen et al. (2015)<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19–46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4:6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 patients: YES<br>6 patient: NO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 patients: positive<br>(2 patient: nephrotic) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 patients: positive<br>6 patients: negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47–312 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1376008.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reported cases of fibronectin glomerulopathy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0085" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Glomerulonephritis with organized deposits: a mesangiopathic, not immune complex-mediated disease? 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 44 | 49 | 93 |
| 2024 September | 45 | 24 | 69 |
| 2024 August | 70 | 64 | 134 |
| 2024 July | 44 | 25 | 69 |
| 2024 June | 64 | 28 | 92 |
| 2024 May | 57 | 27 | 84 |
| 2024 April | 68 | 32 | 100 |
| 2024 March | 63 | 27 | 90 |
| 2024 February | 62 | 41 | 103 |
| 2024 January | 45 | 27 | 72 |
| 2023 December | 47 | 25 | 72 |
| 2023 November | 59 | 28 | 87 |
| 2023 October | 60 | 22 | 82 |
| 2023 September | 67 | 24 | 91 |
| 2023 August | 47 | 20 | 67 |
| 2023 July | 68 | 24 | 92 |
| 2023 June | 57 | 21 | 78 |
| 2023 May | 73 | 35 | 108 |
| 2023 April | 43 | 15 | 58 |
| 2023 March | 79 | 17 | 96 |
| 2023 February | 55 | 19 | 74 |
| 2023 January | 61 | 26 | 87 |
| 2022 December | 82 | 26 | 108 |
| 2022 November | 81 | 33 | 114 |
| 2022 October | 59 | 33 | 92 |
| 2022 September | 36 | 23 | 59 |
| 2022 August | 37 | 49 | 86 |
| 2022 July | 39 | 43 | 82 |
| 2022 June | 42 | 34 | 76 |
| 2022 May | 55 | 55 | 110 |
| 2022 April | 48 | 33 | 81 |
| 2022 March | 39 | 49 | 88 |
| 2022 February | 48 | 40 | 88 |
| 2022 January | 44 | 42 | 86 |
| 2021 December | 47 | 49 | 96 |
| 2021 November | 55 | 34 | 89 |
| 2021 October | 47 | 41 | 88 |
| 2021 September | 43 | 42 | 85 |
| 2021 August | 38 | 39 | 77 |
| 2021 July | 51 | 37 | 88 |
| 2021 June | 48 | 28 | 76 |
| 2021 May | 63 | 63 | 126 |
| 2021 April | 182 | 129 | 311 |
| 2021 March | 69 | 44 | 113 |
| 2021 February | 50 | 33 | 83 |
| 2021 January | 49 | 20 | 69 |
| 2020 December | 35 | 14 | 49 |
| 2020 November | 52 | 28 | 80 |
| 2020 October | 48 | 23 | 71 |
| 2020 September | 52 | 11 | 63 |
| 2020 August | 65 | 20 | 85 |
| 2020 July | 49 | 10 | 59 |
| 2020 June | 32 | 20 | 52 |
| 2020 May | 53 | 13 | 66 |
| 2020 April | 48 | 23 | 71 |
| 2020 March | 33 | 9 | 42 |
| 2020 February | 43 | 23 | 66 |
| 2020 January | 57 | 20 | 77 |
| 2019 December | 37 | 25 | 62 |
| 2019 November | 37 | 23 | 60 |
| 2019 October | 16 | 7 | 23 |
| 2019 September | 27 | 13 | 40 |
| 2019 August | 32 | 15 | 47 |
| 2019 July | 23 | 21 | 44 |
| 2019 June | 41 | 22 | 63 |
| 2019 May | 34 | 17 | 51 |
| 2019 April | 68 | 28 | 96 |
| 2019 March | 36 | 17 | 53 |
| 2019 February | 19 | 14 | 33 |
| 2019 January | 34 | 21 | 55 |
| 2018 December | 125 | 47 | 172 |
| 2018 November | 289 | 19 | 308 |
| 2018 October | 231 | 19 | 250 |
| 2018 September | 98 | 19 | 117 |
| 2018 August | 98 | 18 | 116 |
| 2018 July | 36 | 13 | 49 |
| 2018 June | 35 | 16 | 51 |
| 2018 May | 44 | 15 | 59 |
| 2018 April | 52 | 11 | 63 |
| 2018 March | 51 | 11 | 62 |
| 2018 February | 45 | 7 | 52 |
| 2018 January | 55 | 7 | 62 |
| 2017 December | 50 | 1 | 51 |
| 2017 November | 56 | 9 | 65 |
| 2017 October | 35 | 5 | 40 |
| 2017 September | 38 | 7 | 45 |
| 2017 August | 46 | 5 | 51 |
| 2017 July | 51 | 4 | 55 |
| 2017 June | 41 | 5 | 46 |
| 2017 May | 52 | 9 | 61 |
| 2017 April | 28 | 6 | 34 |
| 2017 March | 14 | 3 | 17 |
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