Collapsing Glomerulopathy: A Single Centre Clinicopathologic Study of Seven Years

• Main Authors: Kamal V. Kanodia, Aruna V. Vanikar, Rashmi D. Patel, Kamlesh S. Suthar, Lovelesh K. Nigam, Himanshu V. Patel, Vivek Kute, Hargovind L. Trivedi
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2016-04-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: end stage renal disease; idiopathic collapsing glomerulopathy; proteinuria; podocyte
• Online Access: https://jcdr.net/articles/PDF/7646/17297_CE(RA1)_F(T)_PF1(RSAK)_PFA(AK)_PF2(PAG).pdf

Introduction: Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy. Aim: A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG. Materials and Methods: A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation. Results: Idiopathic CG constituted 0.75% incidence (25 out of 3335 biopsies) of all biopsies, adults constituting major study part with 88%. The duration of the symptoms at the time of biopsy was 34.12±26.09 days and 35±22.91 days respectively in adults and children. Hypertension was noted in 9(40.9%) and oliguria in 8(36.4%) in adults. Urinalysis revealed microscopic haematuria 12(54.5%) in adults. Nephrotic range proteinuria was reported in 10 (45.5%) adult patients. Glomerular collapse with hyperplasia/ hypertrophy of podocytes was seen in 4.54±3.11 glomeruli. Tubular microcystic dilation was seen in 16(64%) patients. Tubular atrophy involving mild (t1 ) in 15(60%), moderate (t2 ) in 4(16%) and severe (t3 ) in 6(24%) patients. Interstitial fibrosis was mild (i1 ) in 17(68%), moderate (i2 ) in 2(8%) and severe (i3) in 6(24%) patients. Conclusion: Idiopathic CG is a morphological pattern of grave podocyte injury with poor prognosis. However, there are chances of remission/ recovery if the tubular atrophy and interstitial fibrosis are of grades ≤ t1 i1