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Master Thesis

Syndrome néphrotique idiopathique : caractéristiques et identification des facteurs prédictifs d’évolution

Abstract : Introduction: nephrotic syndrome, defined by proteinuria > 3g/day and albuminemia < 30 g/l, can take various histopathologic forms, including minimal change disease (MCD) and focal and segmental glomerulosclerosis (FSGS), which are the propose of this study. Idiopathic nephrotic syndrome represents 15 to 30% in adult glomerulopathies. Its pathophysiology remains partially misunderstood. Nowadays, clinical evolution of idiopathic nephrotic syndrome is not predictable. Patients and methods: the study is a multicentric retrospective descriptive cohort study including all patients aged of 15 years old and more who had renal biopsy concluding minimal change disease or focal and segmental glomerulosclerosis between January 2007 and December 2014. We excluded renal graft biopsies and patients with a follow-up less than two months. Results: we studied 97 idiopathic MCD. Median age was 47 years old. 91.7% of patients were treated with oral corticosteroids for a median total duration of 13 months. During 45 months of follow-up, 92.8% of patients achieved remission and 45.5% experienced relapse with a median delay of 7 months. No statistical association was observed between clinical and biological initial presentation and relapse occurrence. 5% of patients achieved terminal kidney disease. We observed 11% of steroid-induced mellitus diabetes. We studied 68 idiopathic FSGS with a median age was of 57 years old. 51.5% of patients were treated with oral corticosteroids for a median total duration of 15 months. During 66 months of follow-up, 73.5% of patients achieved remission and 20% experienced relapse with a median delay of 14.5 months. We did not observed statistical association between clinical and biological initial presentation and relapse occurrence. 26.5% of patients achieved terminal kidney disease. We observed 11.4% of steroid-induced mellitus diabetes. Conclusion: this study describes a French cohort of MCD and FSGS nephrotic idiopathic syndromes. Multicentric prospective studies might be designed to find new prognostic factors.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01390076
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, October 31, 2016 - 3:36:33 PM
Last modification on : Wednesday, August 23, 2017 - 4:34:01 PM

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Charlotte Mannat Dumas de la Roque. Syndrome néphrotique idiopathique : caractéristiques et identification des facteurs prédictifs d’évolution . Médecine humaine et pathologie. 2016. ⟨dumas-01390076⟩

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