Idiopathic nodular glomerulopathy

José L. Daza, Nephrology, Asociación Colombiana de Nefrología e Hipertensión Arterial, Bogotá, Colombia
Maria P. Joven-Sierra, General Practitioner, Universidad del Tolima, Ibagué, Colombia
Sara J. Oliveros-Rodríguez, General Practitioner, Universidad del Tolima, Ibagué, Colombia
Verónica P. Remache, Renal Pathology, Universidad Rey Juan Carlos, Madrid, España
Vanesa Villavicencio, Nephrology, Universidad Católica de Buenos Aires, Buenos Aires, Argentina
Aldrin D. Sosa, Nephrology, Hospital General Manta, IESS, Manta, Ecuador

Objective: To describe idiopathic nodular glomerulosclerosis (ING) and present the case of a non-diabetic patient with this pathology, its diagnosis, and management. Material and methods: We present the case of a 41-year-old male patient with a history of arterial hypertension, non-diabetic, who was admitted for nephrotic syndrome and renal failure, and was hospitalized for management of proteinuria and deterioration of renal function. Results: Renal biopsy revealed nodular glomerulopathy with global sclerosis, tubular atrophy, interstitial fibrosis and advanced vasculopathy, findings consistent with ING. Management with steroids, anticoagulants, statins and antihypertensive adjustment was initiated, with persistent deterioration of renal function. Conclusions: ING is a diagnosis of exclusion with unfavorable renal evolution, primarily associated with vascular risk factors such as hypertension, and in many cases, smoking, whose therapeutic basis consists of aggressive control of vascular factors.

Keywords: Idiopathic nodular glomerulosclerosis. Kidney biopsy. Arterial hypertension. Smoking. Nephrotic syndrome.