1. Renal survival and treatment of adult patients with Primary Focal Segmental glomerulosclerosis: A historical cohort study of the National Greek Registry.
- Author
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Marinaki, Smaragdi, Kompotiatis, Panagiotis, Michelakis, Ioannis, Stangou, Maria, Papagianni, Aikaterini, Koukoulaki, Maria, Zerbala, Synodi, Xydakis, Dimitrios, Kaperonis, Nikolaos, Dounousi, Evangelia, Golfinopoulos, Spyridon, Stefanidis, Ioannis, Paikopoulou, Aggeliki, Moustakas, George, Stylianou, Kostas, Tzanakis, Ioannis, Papasotiriou, Marios, Goumenos, Dimitrios, Andrikos, Aimilios, and Kriki, Pelagia
- Subjects
FOCAL segmental glomerulosclerosis ,NEPHROTIC syndrome ,IDIOPATHIC diseases ,CYCLOSPORINE ,COHORT analysis - Abstract
Background/Objective: Primary Focal and Segmental glomerulosclerosis (FSGS) is one of the most common causes of idiopathic nephrotic syndrome. Our aim was to describe a large cohort of patients with primary FSGS, identify risk factors associated with worse renal survival and assess the impact of different immunosuppressive regiments on renal survival. Methods: This was a historical cohort study of adults who were diagnosed with primary FSGS from March 26, 1982, to September 16, 2020. The primary outcome was progression to ESRD. Results: We included 579 patients. The mean age was 46 (±15) years of age, with 378 (65%) males and median 24-hour proteinuria was 3.8 (2–6) g. In multivariable analysis only eGFR (HR: 0.97 per ml/min increase, 95% CIs 0.95–0.98) and remission status (complete remission (HR: 0.03, 95% CIs 0.003–0.22) and partial remission (HR: 0.28, 95% CIs 0.13–0.61) compared to no remission) were associated with renal survival. Among patients who received immunosuppression compared to those that did not, there was a higher percentage of complete remission (121 (41%) vs. 40 (24%), p<0.001), and higher percentage of relapses (135 (64%) vs. 27 (33%), p<0.001). Immunosuppression and its type (glucocorticoids vs. cyclosporine ± glucocorticoids) were not associated with renal survival. Conclusion: In primary FSGS, complete and partial remission were associated with improved renal survival. Further randomized studies are needed to assess the efficacy of different therapeutic agents and guide treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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