Study on alpha chain of collagen IV in kidney biopsy of patients affected by nephrotic syndrome and its relation to clinical findings

Abstract

Due to the importance of nephrotic syndrome and its complications and due to the low and heterogeneity of the results of studies on the relationship between different collagen chains and renal function in patients with nephrotic syndrome, the present study aimed to investigate whether the diagnosis of Alport syndrome in Patients using immunohistochemical staining and light microscopy will be performed in centers where electron microscopy is not possible or not. Methods and Materials: A total of 40 patients were evaluated. From patients whose kidney biopsy sample was previously taken in Imam Reza Hospital in Tabriz in the period of April 2018 to March 2020. 20 patients with hematuria and proteinuria and clinical suspicion of Alport syndrome were referred by a nephrologist. The next 20 patients with nephrotic syndrome who had no clinical signs of Alport syndrome and no microscopic findings in favor of Alport syndrome were evaluated. Clinical data of these patients were collected and biopsy specimens of all patients underwent immunohistochemical staining for alpha-3 collagen four chain. Results: In this study, immunohistochemical staining of alpha 3 chain collagen 4 was significantly different in the two groups of patients with Alport syndrome and without Allport syndrome, and negative staining was more in patients with Alport syndrome (P = 0.013). there was no significant difference between the mean glomerular filtration rate between patients with positive staining and patients with negative staining (P = 0.329 in men and P = 0.55 in women). The mean serum creatinine level was significantly different between patients with positive staining and patients with negative staining and was higher in the group of patients with absence or intermittent staining (P = 0.017 in men and P = 0.031 in women). The mean ratio of urine protein to urinary creatinine was significantly different between patients with positive staining and patients with negative staining and was higher in patients with absence or discontinuous staining (P = 0.005 in men and P = 0.011).