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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Background&#58; Chronic kidney disease &#40;CKD&#41; is a growing health problem&#46; About 20&#37; of CKD patients have undetermined causes&#46; Data describing histopathological patterns of unexplained impaired kidney functions in Egypt are lacking&#46; We aimed to identify the clinicopathological characteristics and short-term outcomes of adult cases with unexplained impaired kidney functions&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Methods&#58; We conducted a prospective study in Assiut University Hospital from August 2018 to May 2022&#46; It included patients with unexplained elevated serum creatinine &#40;serum creatinine &#62; 115 &#181;mol&#47;L&#41; who underwent renal biopsies&#46; Descriptive statistics were used to summarize data on patient demographics&#44; histopathological patterns&#44; and outcomes after three months&#46; Clinical trial registration number&#58; NCT03586531&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Results&#58; Overall&#44; 210 native renal biopsies were included in the analysis&#46; Glomerular diseases were the most common pathological finding &#40;n&#61;88&#44; 44&#46;9 &#37;&#41;&#44; amyloidosis and FSGS were the most prevalent glomerular pathology &#40;15&#46;2&#37;&#44; 14&#46;3&#37;&#44; respectively&#41;&#46; Chronic kidney disease of unknown etiology &#40;CKDu&#41; was diagnosed in 8&#46;1&#37; of the cases&#59; histology suggestive of genetic origin was found in 2&#46;5&#37;&#44; and LECT amyloidosis was found in 3&#46;8&#37; of the cases&#46; Poor outcomes were observed in 43&#46;6&#37; of the patients i&#46;e&#46;&#44; renal replacement therapy or death&#46; Treatment strategies were changed based on the biopsy findings in 86 patients &#40;40&#37;&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Conclusion&#58; Amyloidosis and FSGS were the most common causes of unexplained renal impairment&#46; CKDu is not uncommon in Egypt&#44; and more preventive measures are needed&#46; This study supports the irreplaceable role of renal biopsy in disease diagnosis&#44; treatment decisions&#44; and predicting prognosis even in advanced stages&#46;</p></span>"
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Pruebas previas, online el 25 de octubre de 2024
Clinicopathological characteristics and outcomes of patients with unexplained renal impairment: a single center study
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53
Radwa A. Ellisy1,
Autor para correspondencia
radwa.ellisy15@aun.edu.eg

Corresponding author: Division of nephrology, Internal medicine department, Faculty of Medicine, Assiut University, Postal code: 71515, Assiut, Egypt
, Effat A Tony1, Wesam Ismail2, Rabab Radi3, Mohamed Ismail Seddik4, Essam M Abdel Aziz1
1 Division of nephrology, Internal medicine department, Faculty of Medicine, Assiut University, Assiut, Egypt
2 Department of Pathology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
3 Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
4 Clinical pathology Department, Faculty of medicine, Assiut University, Assiut, Egypt
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Abstract

Background: Chronic kidney disease (CKD) is a growing health problem. About 20% of CKD patients have undetermined causes. Data describing histopathological patterns of unexplained impaired kidney functions in Egypt are lacking. We aimed to identify the clinicopathological characteristics and short-term outcomes of adult cases with unexplained impaired kidney functions.

Methods: We conducted a prospective study in Assiut University Hospital from August 2018 to May 2022. It included patients with unexplained elevated serum creatinine (serum creatinine > 115 µmol/L) who underwent renal biopsies. Descriptive statistics were used to summarize data on patient demographics, histopathological patterns, and outcomes after three months. Clinical trial registration number: NCT03586531.

Results: Overall, 210 native renal biopsies were included in the analysis. Glomerular diseases were the most common pathological finding (n=88, 44.9 %), amyloidosis and FSGS were the most prevalent glomerular pathology (15.2%, 14.3%, respectively). Chronic kidney disease of unknown etiology (CKDu) was diagnosed in 8.1% of the cases; histology suggestive of genetic origin was found in 2.5%, and LECT amyloidosis was found in 3.8% of the cases. Poor outcomes were observed in 43.6% of the patients i.e., renal replacement therapy or death. Treatment strategies were changed based on the biopsy findings in 86 patients (40%).

Conclusion: Amyloidosis and FSGS were the most common causes of unexplained renal impairment. CKDu is not uncommon in Egypt, and more preventive measures are needed. This study supports the irreplaceable role of renal biopsy in disease diagnosis, treatment decisions, and predicting prognosis even in advanced stages.

Keywords:
renal biopsy
unexplained renal impairment
CKDu
histopathology
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