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Other types of glomerulonephritis diagnosed were crescentic glomerulonephritis [34], diabetic nephropathy [35], membranoproliferative glomerulonephritis [36], membranous lupus glomerulonephritis [5], diffuse proliferative glomerulonephritis [37] and postinfectious mesangial proliferative glomerulonephritis [36] (each with one patient). Of the 27 patients whose data were available, 18 were male and 9 were female and only 1 female had a diagnosis of focal segmental glomerulosclerosis; the mean age was 44 �� 16 years (40 �� 15 years for male and 53 �� 15 years for female). It is difficult to be certain whether these associations are coincidental or whether they demonstrate a specific pathogenetic relationship with ADPKD. The frequency of focal segmental glomerulosclerosis (6/29, 20%) is higher than the 15% frequency of focal segmental glomerulosclerosis found in the general adult population. In selleck products contrast, membranous nephropathy, the most common cause of idiopathic nephrotic syndrome in adults, with a frequency of 25%, was found in 17% (5/29) of the ADPKD patients with nephrotic syndrome, which suggests that FSGS may be more than a coincidental finding and glomerular hyperfiltration could play an important role in the development of FSGS and heavy proteinuria in patients with ADPKD. Moreover, the coincidence of ADPKD and FSGS can be caused by two independent concurrent genetic mutations which are not necessarily related or one single mutation, which is unknown yet. It is possible that different mutations in these patients could clarify the nature of this coincidence. However, in a histological study of kidneys Everolimus manufacturer of 12 ADPKD patients without nephrotic syndrome, Montoyo et al. [38] reported that interstitial fibrosis and tubular Cofactor atrophy were found to be the main determinants of the development of chronic renal failure in ADPKD. In a study of 18 cases, Zeir et al. [39] reported interstitial fibrosis and arteriolar sclerosis to be the most important lesions in the kidney of ADPKD patients, whereas FSGS was observed in
