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Clinicopathological features and medium-term outcomes of histologic variants of primary focal segmental glomerulosclerosis in adults:A retrospective study

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World Journal of Nephrology 2024年第1期13卷 14-24页

作者： Nazarul Hassan Jafry Shumaila Manan Rahma Rashid Muhammed Mubarak Department of Nephrology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan Department of Pathology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan

BACKGROUND The columbia classification identified five histological variants of focal segmental glomerulosclerosis(FSGS).The prognostic significance of these variants remains *** To evaluate the relative frequency,clinicopathologic characteristics,and medium-term outcomes of FSGS variants at a single center in *** This retrospective study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan on all consecutive adults(≥16 years)with biopsy-proven primary FSGS from January 1995 to December *** subjects were treated with steroids as a first-line *** response rates,doubling of serum creatinine,and kidney failure(KF)with replacement therapy were compared between histological variants using ANOVA or Kruskal Wallis,and Chi-square tests as *** were analyzed by SPSS version 22.0.P-value≤0.05 was considered *** A total of 401 patients were diagnosed with primary FSGS during the study *** these,352(87.7%)had a designated histological *** not otherwise specified(NOS)variant was the commonest,being found in 185(53.9%)patients,followed by the tip variant in 100(29.1%)***(COL),cellular(CEL),and perihilar(PHI)variants were seen in 58(16.9%),6(1.5%),and 3(0.7%)patients,*** and PHI variants were excluded from further analysis due to small patient *** mean follow-up period was 36.5±29.2 *** response rates of variants,patients with TIP lesions achieved remission more frequently(59.5%)than patients with NOS(41.8%)and COL(24.52%)variants(P<0.001).The hazard ratio of complete response among patients with the COL variant was 0.163[95%confidence interval(CI):0.039-0.67]as compared to patients with *** TIP variant showed a hazard ratio of 2.5(95%CI:1.61-3.89)for complete remission compared to the NOS ***,progressive KF was observed more frequently in patients with the COL variant,43.

关键词： Adults columbia classification Focal segmental glomerulosclerosis Histological variants Kidney failure Kidney failure with replacement therapy

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