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

Young Eun Kwon, Seung Hyeok Han, Jeong Hae Kie, Seong Yeong An, Yung Ly Kim, Kyoung Sook Park, Ki Heon Nam, Ah Young Leem, Hyung Jung Oh, Jung Tak Park, Tae Ik Chang, Ea Wha Kang, Shin Wook Kang, Kyu Hun Choi, Beom Jin Lim, Hyeon Joo Jeong, Tae Hyun Yoo

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Abstract

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.

Original languageEnglish
Article number52
JournalBMC Nephrology
Volume15
Issue number1
DOIs
Publication statusPublished - 2014 Mar 25

All Science Journal Classification (ASJC) codes

  • Nephrology

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    Kwon, Y. E., Han, S. H., Kie, J. H., An, S. Y., Kim, Y. L., Park, K. S., Nam, K. H., Leem, A. Y., Oh, H. J., Park, J. T., Chang, T. I., Kang, E. W., Kang, S. W., Choi, K. H., Lim, B. J., Jeong, H. J., & Yoo, T. H. (2014). Clinical features and outcomes of focal segmental glomerulosclerosis pathologic variants in Korean adult patients. BMC Nephrology, 15(1), [52]. https://doi.org/10.1186/1471-2369-15-52