Document 0062
 DOCN  M94A0062
 TI    Collapsing glomerulopathy: a clinically and pathologically distinct
       variant of focal segmental glomerulosclerosis.
 DT    9412
 AU    Detwiler RK; Falk RJ; Hogan SL; Jennette JC; Department of Medicine,
       University of North Carolina, Chapel; Hill.
 SO    Kidney Int. 1994 May;45(5):1416-24. Unique Identifier : AIDSLINE
       MED/94351995
 AB    Sixteen patients with renal biopsy findings of extensive focal
       glomerular capillary collapse, visceral epithelial cell hypertrophy and
       hyperplasia, and variable degrees of tubulointerstitial injury in the
       absence of evidence for human immunodeficiency virus (HIV) infection or
       intravenous drug abuse were prospectively identified by renal biopsy.
       The pathologic process was designated collapsing glomerulopathy to
       distinguish it from other patterns of focal glomerular sclerosis. The
       clinical and pathologic characteristics of these 16 patients were
       analyzed and compared to a group of 25 patients with noncollapsing focal
       segmental glomerulosclerosis (FSGS). Thirteen of 16 patients with
       collapsing glomerulopathy were black as compared with 11 of 25 with FSGS
       (P = 0.018). The most common findings at presentation were hypertension
       and manifestations of the nephrotic syndrome. Although the duration of
       symptoms prior to presentation was no longer in the collapsing
       glomerulopathy group, the presenting mean serum creatinine was higher in
       patients with collapsing glomerulopathy than in those with noncollapsing
       FSGS (3.5 +/- 3.4 mg/dl vs. 1.3 0.6 mg/dl, P = 0.001). Twenty-four-hour
       urine protein excretion was also higher in the collapsing glomerulopathy
       group (13.2 +/- 7.7 g/day vs. 4.6 +/- 4.5 g/day FSGS, P = 0.005). The
       collapsing glomerulopathy patients had a mean age of 41.4 +/- 19.1
       (range 19 to 81), a male-to-female ratio of 11:5 and a black-to-white
       ratio of 13:3. Renal survival, evaluated by life-table analysis, was
       markedly worse in collapsing glomerulopathy patients than in FSGS
       patients (P = 0.0004). It is proposed that collapsing glomerulopathy is
       a distinct entity characterized by black racial predominance, massive
       proteinuria, relatively rapidly progressive renal insufficiency, and
       distinctive pathologic findings.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Adult  Aged  Aged, 80 and over  Capillaries/PATHOLOGY
       Epithelium/PATHOLOGY  Female  Glomerulosclerosis, Focal/*PATHOLOGY
       Human  Hypertrophy  Kidney Diseases/PATHOLOGY  Kidney Glomerulus/*BLOOD
       SUPPLY  Male  Middle Age  JOURNAL ARTICLE

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