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    Clinical and histopathological characteristics of primary focal segmental glomerulosclerosis in Turkish adults
    (Nature Research, 2024) Kurultak, İlhan; Güngör, Özkan; Öztürk, Savaş; Dirim, Ahmet Burak; Eren, Necmi; Yenigün, Ezgi; Dal, Elbis Ahbab
    The data regarding primary FSGS (pFSGS) from different parts of the world differ. While the prevalence of pFSGS has been increasing in Western countries like the USA, it follows an inconsistent trend in Europe and Asia and a decreasing trend in Far Eastern countries such as China in the last two decades. There are undetermined factors to explain those national and geographic discrepancies. Herein, we aimed to reveal the current prevalence with clinical and histopathological characteristics of pFSGS in Turkish adults. This study includes the biopsy-proven pFSGS patients data recorded between 2009 and 2019, obtained from the national multicenter primary glomerulonephritis registry system of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database. 850 of the 3875 primer glomerulonephritis patients(21.9%) have pFSGS. The mean age is 40.5 ± 14.2 and 435 (51.2%) of patients are male. Nephrotic syndrome is the most common biopsy indication (59.2%). 32.6% of patients have hematuria, 15.2% have leukocyturia and 7.8% have both. Serum creatinine, albumin, and proteinuria are 1.0 mg/dL (IQR = 0.7–1.4) mg/dl, 3.4 ± 0.9 g/dl, 3400 mg/day(IQR, 1774–5740), respectively. Females have lower mean arterial pressure (? 2.2 mmHg), higher eGFR (+ 10.0 mL/min/1.73 m2), and BMI (+ 1.6 kg/m2) than males. Thickened basal membrane(76.6%) and mesangial proliferation (53.5%) on light microscopy are the major findings after segmental sclerosis. IgM (32.7%) and C3 (32.9%) depositions are the most common findings on immunofluorescence microscopy. IgM positivity is related to lower eGFR, serum albumin, and higher proteinuria. The prevalence of pFSGS is stable although slightly increasing in Turkish adults. The characteristics of the patients are similar to those seen in Western countries. © The Author(s) 2024.
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    Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group
    (BioMed Central Ltd, 2020) Türkmen, Aydın; Şumnu, Abdullah; Cebeci, Egemen; Yazıcı, Halil; Eren, Necmi; Seyahi, Nurhan; Dilek, Kamil; Dede, Fatih; Derici, Ülver Boztepe; Ünsal, Abdülkadir; Şahin, Garip; Sipahioǧlu, Murat Hayri; Gok, Mahmut; Tatar, Erhan; Dursun, Belda; Sıpahı, Savaş; Yılmaz, Mürvet; Süleymanlar, Gültekin; Ulu, Sena Memnune; Güngör, Özkan; Kutlay, Sim; Bahçebaşı, Zerrin Bicik; Şahin, Ídris; Kurultak, İlhan; Türkmen, Kültigin; Yılmaz, Zülfikar; Kazancıoğlu, Rümeyza Turan; Çavdar, Caner; Candan, Ferhan; Aydın, Zeki; Oygar, Düriye Deren; Gul, Cuma Bulent; Arici, Mustafa; Paydaş, Saime; Taymez, Dilek Güven; Küçük, Mehmet; Trablus, Sinan; Turgutalp, Kenan; Koç, Leyla; Sezer, Siren; Duranay, Murat; Bardak, Simge; Altıntepe, Lütfullah; Arikan, Izzet Hakki; Azak, Alper; Odabaş, Ali Rıza; Şahin, Gülizar Manga; Ozturk, Savas
    Abstract Background: The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods: Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results: The mean age was 41.5 ± 14.9 years. 1690 patients were female (43.6%) and 2185 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGD was IgA nephropathy (25.7%) followed by membranous nephropathy (25.6%) and focal segmental glomerulosclerosis (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. The mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467–6307) mg/day, 1.0 (IQR: 0.7–1.6) mg/dL, 82.9 (IQR: 47.0–113.0) mL/min and 3.2 ± 0.9 g/dL, respectively. Conclusions: The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy. Keywords: Epidemiology, Glomerulonephritis, Kidney biopsy, Primary glomerular diseases; the Turkish Society of Nephrology glomerular diseases (TSN-GOLD) working group, Turkish Society of Nephrology
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    The relationship between glomerular IgG staining and poor prognostic findings in patients with IgA nephropathy: the data from TSN-GOLD working group
    (BioMed Central Ltd, 2021) Turgutalp, Kenan; Cebeci, Egemen; Türkmen, Aydın; Derici, Ülver Boztepe; Seyahi, Nurhan; Eren, Necmi; Dede, Fatih; Güllülü, Mustafa; Baştürk, Taner; Şahin, Gülizar Manga; Yılmaz, Mürvet; Sipahi, Savaş; Şahin, Garip; Ulu, Sena Memnune; Tatar, Erhan; Gündogdu, Ali; Kazancıoğlu, Rümeyza Turan; Sevinç, Can; Güngör, Özkan; Şahin, İdris; Kutlay, Sim; Kurultak, İlhan; Aydın, Zeki; Altun, Bülent; Dursun, Belda; Yılmaz, Zülfükar; Uzun, Özcan; Süleymanlar, Gültekin; Candan, Ferhan; Sezer, Siren; Tanburoğlu, Derya Basak; Bicik, Zerrin; Taymez, Dilek Güven; Akcali, Esra; Oygar, Düriye Deren; İstemihan, Zülal; Bardak, Simge; Bardak, Simge; Akçay, Ömer Faruk; Dincer, Mevlüt Tamer; Dervişoğlu, Erkan; Yenigün, Ezgi Çoşkun; Türkmen, Kültigin; Özturk, Savaş
    Background: Galactose-deficient IgA1 (Gd-IgA1) has an increased tendency to form immunocomplexes with IgG in the serum, contributing to IgAN pathogenesis by accumulating in the glomerular mesangium. Several studies showed that glomerular IgG deposition in IgAN is an important cause of mesangial proliferation and glomerular damage. This study aims to determine the association of the positivity of IgG and the intensity of IgG staining with a poor renal prognosis. Methods: A total of 943 IgAN patients were included in the study. Glomerular IgG staining negative and positive patients were compared using Oxford classification scores, histopathological evaluations, proteinuria, eGFR, albumin, blood pressures. IgG positive patients were classified as (+), (++), (+++) based on their staining intensity, and the association with the prognostic criteria was also evaluated. Results: 81% (n = 764) of the patients were detected as IgG negative, while 19% (n = 179) were positive. Age, gender, body mass index, blood pressure, proteinuria, eGFR, uric acid values were similar in IgG positive and negative patients who underwent biopsy (p > 0.05). Intensity of glomerular IgG positivity was not found to be associated with diastolic and systolic blood pressure, urea, uric acid, age, eGFR, albumin, proteinuria (p > 0.05 for all, r = − 0.084, r = − 0.102, r = − 0.006, r = 0.062, r = 0.014, r = − 0.044, r = − 0.061, r = − 0.066, r = 0.150, respectively). There was no difference for histopathological findings between IgG (+), IgG (++), IgG (+++) groups (for all, p > 0.05). Conclusion: Glomerular IgG negativity and positivity detected by routine IFM in IgAN patients is not associated with poor renal prognostic risk factors.