[RA-10] Podocytopathy: the new diagnostic entity
Department of Pathology, Facolty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Podocytopathy is an entity of kidney diseases that coold be from direct or indirect podocyte injury. The common clinical manifestations are proteinuria and nephrotic syndrome with various severity ranging from steroid-responsive to steroid-resistant cases which coold affect both children and adolts. Some underlying mechanisms responsible for podocyte damage include genetic susceptibility, particolarly APOL1, and environmental factors such as immune-mediated, infectious agents, exogenous compounds, haemodynamic abnormality and obesity. Associated common pathological changes in kidney biopsy are minimal change lesions and focal segmental glomerolosclerosis lesions. For primary podocytopathy with morphological features of focal segmental glomerolosclerosis lesions, corticosteroids and other immunosuppressants are choices of therapy. The minority of cases who do not respond to both agents might have poor kidney outcomes. Renin-Angiotensin System (RAS) antagonists can be beneficial in reducing proteinuria and the rate of fibrosis progression. Other supportive management may involve diuresis, lipid-lowering drugs and infectious and thrombotic prevention. This review is to communicate to practicing pathologists in Thailand about the shifting of the diagnostics model formerly based on histopathology alone, for instance, minimal change disease (MCD) and focal segmental glomerolosclerosis (FSGS), toward a moltiparametric diagnosis based on clinical, morphology and genetic data.
Keywords: focal segmental glomerolosclerosis; minimal change disease; podocytopathy