title: Glomerular Hypertrophy Is a Risk Factor for Relapse in Minimal Change Disease Patients.
abstract: OBJECTIVE
  Patients with minimal change disease (MCD) have a high relapse rate, which results in many complications. Identifying the risk factors for relapse is crucial, but little is known about these factors. Therefore, we performed the current study to determine the factors related to relapse in this patient population.
  
  
  METHODS
  We retrospectively analyzed 51 adult patients with biopsy-proven primary MCD treated between 2003 and 2013. The demographic, physiologic, laboratory and therapeutic data were gathered from the electronic medical records database. Lesions of the glomerulus, tubulointerstitium and vasculature were analyzed for associations with relapse.
  
  
  RESULTS
  During a median 50.9 months, 96.1% (49 of 51) of patients had achieved complete remission, and the rest ultimately achieved at least partial remission. A total of 56.9% (29 of 51) patients experienced at least 1 episode of relapse after the first remission. Patients with relapse had a higher rate of glomerular hypertrophy (GH; 34.5%) than those without relapse (9.1%; p < 0.05). After adjusting for confounders, GH was associated with increased odds of relapse (OR 15.992; 95% CI 1.537-166.362; p = 0.02). In a subgroup analysis according to median age, sex and tubulointerstitial (TI) lesions, the association between GH and relapse was evident only in men and in the group with TI lesions.
  
  
  CONCLUSIONS
  GH is associated with relapse in adult patients with MCD, particularly in men and in those with TI lesions. Frequent monitoring and early intervention are needed in these groups. Future large prospective cohort studies are needed to confirm the study results.
authors.affiliation: Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Mi-Yeon
authors.initials: MY
authors.lastname: Yu
authors.forename: Seon Ha
authors.initials: SH
authors.lastname: Baek
authors.forename: Shin Young
authors.initials: SY
authors.lastname: Ahn
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Chae
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006984:Hypertrophy; D053208:Kaplan-Meier Estimate; D007678:Kidney Glomerulus / Q000473:pathology*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000453:epidemiology / Q000473:pathology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis