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Glomerular nestin expression: possible predictor of outcome of focal segmental glomerulosclerosis in children

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Abstract

Background

A high prevalence of chronic kidney disease among children with focal segmental glomerulosclerosis (FSGS) leads to a permanent quest for good predictors of kidney dysfunction. Thus, we carried out a retrospective cohort study in order to examine known clinical and morphological predictors of adverse outcome, as well as to investigate glomerular nestin expression as a potential new early predictor of kidney dysfunction in children with FSGS. Relationships between nestin expression and clinical and morphological findings were also investigated.

Methods

Among 649 renal biopsy samples, obtained from two children’s hospitals, FSGS was diagnosed in 60 children. Thirty-eight patients, who met the criteria for this study, were followed up for 9.0 ± 5.2 years. Using Kaplan–Meier and Cox’s regression analysis, potential clinical and morphological predictors were applied in two models of prediction: after disease onset and after the biopsy.

Results

The present study revealed the following significant predictors of kidney dysfunction: patients’ ages at disease onset, as well as age at biopsy, resistance to corticosteroid treatment, serum creatinine level, urine protein/creatinine ratio, vascular involvement, tubular atrophy, interstitial fibrosis, and decreased glomerular nestin expression.

Conclusions

The most important finding of our study is that nestin can be used as a potential new early morphological predictor of kidney dysfunction in childhood onset of FSGS, since nestin has been obviously decreased in both sclerotic and normal glomeruli seen by light microscopy.

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Acknowledgement

This work was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia, project number OI 175047.

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Authors and Affiliations

  1. Medical Faculty, University of Belgrade, Belgrade, Serbia

    Maja Životić, Radovan Bogdanović, Amira Peco-Antić, Dušan Paripović, Nataša Stajić, Jelena Vještica, Sanja Ćirović, Goran Trajković & Jasmina Marković-Lipkovski

  2. Institute of Pathology, Medical Faculty, University of Belgrade, Dr Subotića 1, 11000, Belgrade, Serbia

    Maja Životić, Jelena Vještica, Sanja Ćirović & Jasmina Marković-Lipkovski

  3. Department of Nephrology, Institute of Mother and Child Health Care, Belgrade, Serbia

    Radovan Bogdanović & Nataša Stajić

  4. Department of Nephrology, University Children’s Hospital, Belgrade, Serbia

    Amira Peco-Antić & Dušan Paripović

  5. Institute of Medical Statistics and Informatics, Belgrade, Serbia

    Goran Trajković

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  1. Maja Životić
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  2. Radovan Bogdanović
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  9. Jasmina Marković-Lipkovski
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Correspondence to Jasmina Marković-Lipkovski.

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Životić, M., Bogdanović, R., Peco-Antić, A. et al. Glomerular nestin expression: possible predictor of outcome of focal segmental glomerulosclerosis in children. Pediatr Nephrol 30, 79–90 (2015). https://doi.org/10.1007/s00467-014-2893-5

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  • DOI: https://doi.org/10.1007/s00467-014-2893-5

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