Renal survival and treatment of adult patients with Primary Focal Segmental glomerulosclerosis: A historical cohort study of the National Greek Registry

• Published in: PloS one 2024-12, Vol.19 (12), p.e0315124
• Main Authors: 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, Kriki, Pelagia, Panagoutsos, Stylianos, Kiousi, Eva, Grapsa, Eirini, Koutroumpas, Georgios, Pateinakis, Panagiotis, Papadopoulou, Dorothea, Liakopoulos, Vasilios, Bacharaki, Dimitra, Kouki, Penelope, Petras, Dimitrios, Bamichas, Gerasimos, Boletis, Ioannis
• Format: Article
• Language: English
• Subjects: Adult; Biology and Life Sciences; Blood pressure; Care and treatment; Cohort analysis; Cohort Studies; Cyclosporins; Diagnosis; Disease Progression; Etiology; Female; Glomerular Filtration Rate; Glomerulosclerosis, Focal Segmental - drug therapy; Glucocorticoids; Greece - epidemiology; Humans; Immunosuppression; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Kidney - pathology; Kidney diseases; Kidney Failure, Chronic - mortality; Kidneys; Laboratories; Male; Medical prognosis; Medicine and Health Sciences; Middle Aged; Nephrotic syndrome; Patients; Pharmacology; Proteins; Proteinuria; Registries; Remission; Remission (Medicine); Remission Induction; Research and Analysis Methods; Risk Factors; Survival; Urine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0315124

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. 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. 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