Autosomal Dominant Polycystic Kidney Disease With Idiopathic Membranous Nephropathy: An Unusual Association?
Bibliographic record
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is usually characterized by proteinuria less than 1 g/24 hours and only anecdotal cases of associated nephrotic syndrome have been reported. We report another case of ADPKD with nephrotic syndrome, where histological examination showed features of membranous glomerulonephritis. Serologic tests for hepatitis B surface antigen and anti-hepatitis C antibodies were negative. Antinuclear antibody and anti-neutrophil cytoplasmic antibody were negative. Serum complement fraction, C3 and C4, were within normal range. Abdominal ultrasound examination showed both enlarged liver and kidneys, both with multiple cysts of varying sizes. Nevertheless renal parenchyma between cysts was not yet widely interested. Family history revealed ADPKD affecting the mother. Considering nephrotic proteinuria, a percutaneous biopsy was performed, and a diagnosis of idiopathic membranous nephropathy associated with ADPKD was made. Our patient was managed with salt restriction, diuretics and antihypertensive drugs (ACE-I and ARB) and started therapy according to Ponticelli's Protocol. At 12 week follow up proteinuria dropped to less than 1 g/24 hours, with normalization of renal function. Our case confirmed the importance of kidney biopsy even in patients with ADPKD and nephrotic syndrome, in order to demonstrate any coexisting glomerular disease, make an accurate diagnosis and plan appropriate treatment. doi:10.4021/jmc144w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".