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Gigante A, Cianci R, Villa A, Pellicano C, Giannakakis K, Rosato E, Spinelli FR, Basile U, Racco C, Di Virgilio EM, Cerbelli B, Conti F. Kidney Biopsy and Immuno-Rheumatological Diseases: A Retrospective and Observational Study. J Pers Med 2024; 14:92. [PMID: 38248794 PMCID: PMC10819986 DOI: 10.3390/jpm14010092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Renal involvement is a common occurrence in patients with immuno-rheumatological diseases (IRDs). Several instances of glomerulonephritis (GN) occur in the setting of IRD and complicate the clinical course of an underlying condition. The aim of this study was to observe the spectrum of nephropathies according to age, kidney function, history of IRD at the time of biopsy, and histopathological kidney diagnosis. We evaluated data relating to 699 consecutive kidney native biopsies (female 52.1%) with a median age of 48 years (IQR 34-62) performed in adult patients collected over 15 years. The study population was divided into three groups: patients with kidney histological findings correlated to underlying IRD (Group 1), patients with kidney histological findings not correlated to underlying IRD (Group 2), and patients with kidney histological findings compatible with "de novo" IRD (absent in personal medical history) (Group 3). Kidney involvement related to IRD was found in 25.2% of patients. Group 1 was mostly represented by lupus nephritis (76.6%), with a younger age than Group 3 (p < 0.001) and by a higher percentage of females than other groups (p < 0.001). Group 3 was the most represented by microscopic polyangiitis (50.8%) when compared with the other two groups (p < 0.001). Acute nephritic syndrome (p < 0.001), acute kidney injury (AKI), and abnormal urinalysis (p < 0.001) were more represented in Group 3 than the other groups. In conclusion, IRDs are characterized by different clinical presentations and heterogeneous histological findings. Kidney biopsy remains fundamental to achieving the correct diagnosis and starting targeted therapy.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Annalisa Villa
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Konstantinos Giannakakis
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Francesca Romana Spinelli
- Rheumatology Unit, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy (F.C.)
| | - Umberto Basile
- Department of Clinical Pathology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy;
| | - Cosimo Racco
- Department of Clinical Pathology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy;
| | - Elena Maria Di Virgilio
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Bruna Cerbelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Fabrizio Conti
- Rheumatology Unit, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy (F.C.)
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