Focal glomerular sclerosis in non-nephrotic patients with hyperlipidemia

Takao Saito, Hiroshi Sato, Naoki Akiu, Tetsuya Ootaka, Takashi Furuyama, Kaoru Yoshinaga

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Kidney biopsy specimens obtained from 4 non-nephrotic patients with hyperlipidemia showed the histology of focal glomerular sclerosis (FGS). One young patient had demonstrated proteinuria since the age of 15. He was obese and revealed genital malformation. However, his familial history was unremarkable for hyperlipidemia. The other 3 were found to have proteinuria in their thirties and underwent renal biopsies. The proteinuria was not so heavy as to induce hypoalbuminemia in all patients. They had no edema. The observed lipoprotein abnormalities were classified as type IV on the WHO classification in 2 patients and type V in one patient. On light microscopy, the focal segmental sclerotic lesions with hyaline deposits were identical to those generally seen in nephrotic patients. Glomerular IgM and C3 deposition was demonstrated in all patients except one in whom only C3 were deposited. The prognosis was rather poor. Renal function was deteriorated in 3 patients. One of them was sufficiently aggravated as to require hemodialysis. The other patient died of myocardial infarction. It is suggested that lipid toxicity may play an important role in the development of sclerosis in such non-nephrotic and hyperlipidemic patients, because other injurious factors causing nephrotic syndrome, i.e., hemodynamic abnormality or hypoalbuminemic hypercoagulability, do not operate. The role of lipids is supported by some experimental evidence in hyperlipidemic animals which displayed glomerular sclerosis.

Original languageEnglish
Pages (from-to)1107-1114
Number of pages8
JournalJapanese Journal of Nephrology
Volume29
Issue number9
DOIs
Publication statusPublished - 1987 Jan 1

Keywords

  • focal glomerular sclerosis
  • hyperlipidemia
  • nephrotic syndrome

ASJC Scopus subject areas

  • Nephrology

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