Treatment results of patients diagnosed with primary glomerular disease treated at Bezmialem Vakif University Health Practice and Research Center Nephrology Clinic

Introduction and Aim: Primary glomerular diseases (PGD) have an important place in the practice of nephrology and are the third leading cause of end-stage renal disease in our country. There are different types of primary glomerular diseases with different etiologies, clinical and laboratory findings and outcomes. Clinical features and treatment responses of glomerular diseases may differ in diverse populations. It is important to know these characteristics in order to develop an effective treatment approach [1]. The aim of this study was to determine the clinical features, laboratory and histopathological findings in renal biopsy at presentation, complications related to the treatments applied or the disease itself, to determine both renal and patient survival, and the factors affecting survival in patients with primary glomerular disease who were followed up and treated at Bezmialem Vakıf University Health Application and Research Center Nephrology Clinic. Materials and Methods: Clinical parameters, including renal biopsy data, of patients followed up in Bezmialem Vakif University Health Application and Research Center Nephrology Clinic between 2014 and 2022 with the diagnosis of PGD were recorded through the hospital information management system and analyzed. The treatments given to patients during the follow-up period, their response to treatment, complications and side effects related to the treatments given and primary diseases were evaluated. Results: A total of 433 renal biopsies were performed in the nephrology clinic between August 2014 and December 2022. 196 of the 433 patients with PGH were included in the study and their clinical and laboratory features, histopathologic findings and follow-up data were analyzed. The most common disease was IgA nephropathy (43.3%), followed by focal segmental glomerulosclerosis (24.4%), membranous nephropathy (19.3%), minimal change disease and membranoproliferative glomerulonephritis. The most common indication for biopsy was nephrotic syndrome (38.3%), followed by asymptomatic urinary abnormalities (21.9%). In general, tGFH levels were preserved in MCD patients, whereas tGFH levels were lower in MPGN patients compared to other groups. Proteinuria levels were lowest in IgAN, but no significant difference was observed between the other groups. According to histopathologic features, the number of segmental sclerotic glomeruli was significantly higher in the FSGS group; mesengial proliferation was more frequent in the IgAN and MPGN groups compared to the other groups and subepithelial deposition was significantly more frequent in the MN group. Endocapillary proliferation was most frequent in IgAN and MPGN patient groups. IgG deposition was observed in all MPGN and MN patients and IgA deposition was observed in almost all IgAN patients. C3 deposition was observed in all MPGN patients. A total of 106 patients received immunosuppressive treatment. No significant difference was observed when the initial treatment response and the response status of the patients at the endpoint were analyzed according to the variables. Conclusion: The clinical characteristics, histopathologic findings and biopsy indications of patients diagnosed with PGH who were biopsied and/or followed up in our clinic were consistent with the data of previous PGH studies conducted in our country. Treatments given to the patients were in accordance with the current guidelines of the period. Treatment results were analyzed comparatively according to sub-parameters and no significant difference was observed. The reason for this is thought to be the insufficient number of patients in the subgroups. Keywords: Bezmialem, vakif, university, primary, glomerular, disease, glomerulonephritis, IgA, nephropathy, focal, segmental, glomerulosclerosis, membranous, minimal, change, membranoproliferative.