Martínez AI, Carrillo SY, Conrado HJ

Language: Spanish
References: 0
Page: 84-92
PDF size: 438.79 Kb.

ABSTRACT

A 54-year-old female patient with a history of arterial hypertension is admitted to the Nephrology ward of the Salvador Allende Hospital in January 2017 for presenting one-month-old frothed urine, eyelid edema and limbs lower, which progressively increased until high blood pressure. Complementary findings include marked low serum albumin, nephritic range proteinuria and hyperlipidemia and moderate renal dysfunction. Renal biopsy is performed concluding as a Focal segmental glomerular sclerosis variant tip lesion and begins oral steroid treatment at high doses and steroid pulses. It was observed that even though the histological variant Tip lesion presents a complete or partial remission of proteinuria in more than 76% of cases and improvement of renal function, it did not happen in our patient, where proteinuria remained in nephritic range at 6 months of treatment and elevated renal function without variations. For this reason, the epidemiological, clinical and histological aspects that help to predict the course of the GESF are evaluated, emphasizing the value of neuromuscular proteinuria in the pathogenesis of the entity and the risk factor for progression to renal disease progressive Concluding that not always the histological variety of the lesion and the degree of tubule interstitial damage determines the non-therapeutic response, so that the damage must always be treated; that massive proteinuria, presence of interstitial fibrosis and atrophy, as well as non-response are risk factors for progression of kidney disease.