title: Clinical and renal biopsy findings predicting outcome in renal thrombotic microangiopathy: a large cohort study from a single institute in China.
abstract: OBJECTIVE
  The current study aimed to investigate the spectrum of etiologies and associated disorders of renal biopsy-proven thrombotic microangiopathy (TMA) patients.
  
  
  METHODS
  The clinical, laboratory, and renal histopathological data of patients with renal TMA from 2000 to 2012 in our institute were collected and reviewed.
  
  
  RESULTS
  One hundred and nine TMA patients were enrolled in this study. The mean age was 34.0 ± 11.1 years. Seventy patients (64.2%) were male and thirty-nine patients (35.8%) were female. There were eight patients (7.3%) with hemolytic uremic syndrome (HUS). Sixty-one patients (56.0%) were secondary to malignant hypertension. Fourteen patients (12.8%) were pregnancy-associated TMA. Other associated disorders included 17 patients with connective tissue disorders, 2 patients with hematopoietic stem cell transplantation, 4 patients with Castleman's disease, 1 patient with cryoglobulinemia, and 2 patients with glomerulopathy. During followup, 8 patients died due to severe infection, 17 patients had doubling of serum creatinine, and 44 had end-stage renal disease. In multivariate analysis, male, elevated serum creatinine, and decreased hemoglobin were independently associated with poor renal outcomes.
  
  
  CONCLUSIONS
  Renal TMA changes consisted of different disorders with various etiologies. aHUS, pregnancy-associated TMA, and malignant hypertension accounted for the majority of patients in our cohort.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China.
authors.forename: Xiao-Juan
authors.identifier: 0000-0003-1007-3775
authors.initials: XJ
authors.lastname: Yu
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China.
authors.forename: Feng
authors.identifier: 0000-0003-3060-6233
authors.initials: F
authors.lastname: Yu
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China.
authors.forename: Di
authors.initials: D
authors.lastname: Song
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China.
authors.forename: Su-Xia
authors.initials: SX
authors.lastname: Wang
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Chinese PLA General Hospital, 51 Fucheng Road, Beijing 100048, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing 100034, China ; Peking-Tsinghua Center for Life Sciences, Beijing 100871, China.
authors.forename: Ming-Hui
authors.identifier: 0000-0003-3340-3108
authors.initials: MH
authors.lastname: Zhao
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D010951:Plasma Exchange; D011379:Prognosis; D012189:Retrospective Studies; D057049:Thrombotic Microangiopathies / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents