Kidney Outcome in Primary Focal Segmental Glomerulosclerosis (FSGS) by Using a Predictive Model

Authors

  • Shahrzad Ossareh Department of Medicine, Nephrology Section, Iran University of Medical Sciences (IUMS), Hasheminejad Kidney Center (HKC), Tehran, Iran Author
  • Mansoureh Yahyaei Department of Pathology, IUMS- HKC, Tehran, Iran Author
  • Mojgan Asgari Department of Pathology, IUMS- HKC, Tehran, Iran Author
  • Hadia Bagherzadegan Department of Medicine, Nephrology Section, IUMS, Rasoole Akram Hospital, Tehran, Iran Author
  • Hanri Afghahi Department of Nephrology, Skaraborg Hospital, Skovde, Sweden Author

Abstract

Introduction. Focal segmental glomerulosclerosis (FSGS) is one of the important causes of end stage kidney disease (ESKD). We evaluated the progression risk factors of primary FSGS to chronic kidney disease (CKD) or ESKD with a predictive model including clinical and histological predictors. Methods. 201 patients with primary FSGS (59% male, mean age: 38 ± 15 years), were studied. Time-dependent Cox model and C statistics were used for the predictive model. Interaction and correlation between independent variables were estimated. Results. During 55 ± 27 months of follow-up, 82 patients (41%) developed CKD (46) or ESKD (36) patients. In adjusted model, 1 unit of higher serum creatinine (SCr) at baseline (HR = 1.39, 95% CI: 1.15 to 1.70) and 1% increase in glomeruli with segmental glomerulosclerosis (SGS) (HR = 1.03, 95% CI: 1.02 to 1.04) or interstitial fibrosis/tubular atrophy (IF/TA) (HR = 1.03, 95% CI: 1.01 to 1.05) increased the risk of CKD/ESKD. In adjusted model, higher baseline proteinuria and collapsing variant were not associated with risk of CKD/ESKD. By adding SGS and IF/TA scores to baseline SCr in the model, discrimination by C statistics was 0.83 (95% CI: 0.77 to 0.90). Median renal survival was 3.1 years (95% CI: 2.2 to 4.1 years) in patients with highest risk score (baseline eGFR < 25 mL/min/1.73m2 + IF/TA/SGS > 50%), and 8.1 years (95% CI: 7.7 to 8.6 years).in those with lowest score (baseline eGFR > 75 mL/ min/1.73m2 + IF/TA/SGS < 5%). Conclusion. In primary FSGS, higher baseline SCr, increased SGS and IF/TA, but not baseline proteinuria and collapsing pathology, were the predictors for CKD/ESKD. These findings indicated the importance of timely detection and referral in prognosis of primary FSGS.

 

DOI: 10.52547/ijkd.6442

Downloads

Download data is not yet available.

Author Biographies

  • Shahrzad Ossareh, Department of Medicine, Nephrology Section, Iran University of Medical Sciences (IUMS), Hasheminejad Kidney Center (HKC), Tehran, Iran

    Shahrzad Ossareh- M.D. 
    Professor of Medicine 
    Head, Section of Nephrology and Hemodialysis Ward, Hasheminejad Kidney Center, Iran University of Medical Sciences

    Director of Nephrology and Fellowship Program, Hasheminejad Kidney Center, Iran University of Medical Sciences

    Address: Vanak sq., Tehran 1969714713-Iran 

     

    Tel: 0098-21-8864 4420, Fax: 0098-21-8864 4441

     

  • Mansoureh Yahyaei, Department of Pathology, IUMS- HKC, Tehran, Iran

     

    Department of Medicine, Nephrology section, Iran University of Medical Sciences (IUMS), Hasheminejad Kidney Center (HKC), Tehran, Iran

     

  • Mojgan Asgari, Department of Pathology, IUMS- HKC, Tehran, Iran

     

    Associate Professor, Department of Pathology, Iran University of Medical Sciences, Iran University of Medical Sciences, Hasheminejad Kidney Center, Tehran, Iran

     

  • Hadia Bagherzadegan, Department of Medicine, Nephrology Section, IUMS, Rasoole Akram Hospital, Tehran, Iran

    Assistant Professor of Medicine,

    Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran

     


  • Hanri Afghahi, Department of Nephrology, Skaraborg Hospital, Skovde, Sweden

     

    Department of Nephrology, Skaraborg Hospital, Skövde, Sweden,

     

Downloads

Published

2021-12-20

Issue

Section

ORIGINAL | Kidney Diseases

How to Cite

Kidney Outcome in Primary Focal Segmental Glomerulosclerosis (FSGS) by Using a Predictive Model. (2021). Iranian Journal of Kidney Diseases, 15(6), 408-418. https://www.ijkd.org/index.php/ijkd/article/view/6442

Most read articles by the same author(s)

1 2 3 > >>