Clinical features and outcomes of focal segmental glomerulosclerosis pathologic variants in Korean adult patients

BMC Nephrology

Tae-Hyun Yoo¹  Hyeon Joo Jeong⁴  Beom Jin Lim⁴  Kyu Hun Choi¹  Shin-Wook Kang¹  Ea Wha Kang²  Tae Ik Chang²  Jung Tak Park¹  Hyung Jung Oh¹  Ah Young Leem¹  Ki Heon Nam¹  Kyoung Sook Park¹  Yung Ly Kim¹  Seong Yeong An¹  Jeong Hae Kie³  Seung Hyeok Han¹  Young Eun Kwon¹ 

[1] Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-Gu, Seoul 120-752, Korea;Department of Internal Medicine, NHIS Medical Center Ilsan Hospital, Goyang-shi, Gyeonggi-do, Korea;Department of Pathology, NHIS Medical Center Ilsan Hospital, Goyang-shi, Gyeonggi-do, Korea;Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

关键词: Outcome;    Pathology;    Focal segmental glomerulosclerosis;   

Others  :  1082708
DOI  :  10.1186/1471-2369-15-52

 received in 2013-10-30, accepted in 2014-03-20,  发布年份 2014

【 摘 要 】

Background

Many studies have shown that clinical characteristics and outcomes differ depending on pathologic variants of focal segmental glomerulosclerosis (FSGS). However, these are not well defined in Asian populations.

Methods

This retrospective study evaluated clinical features and outcomes of pathologic FSGS variants in 111 adult patients between January 2004 and December 2012. Primary outcome was the composite of doubling of baseline serum creatinine concentrations (D-SCr) or onset of end-stage renal disease (ESRD). Secondary outcome included complete (CR) or partial remission (PR).

Results

There were 70 (63.1%), 20 (18.0%), 17 (15.3%), 3 (2.7%), and 1 (0.9%) patients with not-otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants, respectively. At presentation, nephrotic-range proteinuria occurred more commonly in tip lesion than in other variants. The overall 5-year renal survival rate was 76.8%. During a median follow-up of 34.5 months, only 1 (5.0%) patient with a tip lesion reached the composite end point compared to 2 (11.8%) and 12 (17.1%) patients in perihilar and NOS variants, but this difference was not statistically significant in an adjusted Cox model. However, tip lesion was associated with a significantly increased probability of achieving CR (P = 0.044).

Conclusion

Similar to other populations, Korean adult patients with FSGS have distinct clinical features with the exception of a rare frequency of cellular and collapsing variants. Although pathologic variants were not associated with overall outcome, the tip variant exhibited favorable outcome in terms of achieving remission. Further studies are required to delineate long-term outcome and response to treatment of the pathologic variants.

【 授权许可】

   
2014 Kwon et al.; licensee BioMed Central Ltd.

【 图 表 】

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