Renal Survival in Patients with Collapsing Compared with Not Otherwise Specified FSGS

Idiopathic collapsing FSGS has historically been associated with poor renal outcomes. Minimal clinical data exist on the efficacy of immunosuppressive therapy. Our study sought to provide a comprehensive description of renal survival in patients with collapsing and not otherwise specified FSGS after...

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Published in:Clinical journal of the American Society of Nephrology 2016-10, Vol.11 (10), p.1752-1759
Main Authors: Laurin, Louis-Philippe, Gasim, Adil M, Derebail, Vimal K, McGregor, JulieAnne G, Kidd, Jason M, Hogan, Susan L, Poulton, Caroline J, Detwiler, Randal K, Jennette, J Charles, Falk, Ronald J, Nachman, Patrick H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biopsy
Calcineurin Inhibitors - therapeutic use
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate
Glomerulosclerosis, Focal Segmental - complications
Glomerulosclerosis, Focal Segmental - drug therapy
Glomerulosclerosis, Focal Segmental - pathology
Glomerulosclerosis, Focal Segmental - physiopathology
Glucocorticoids - therapeutic use
Humans
Immunosuppressive Agents - therapeutic use
Kidney - pathology
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - therapy
Kidney Transplantation
Male
Middle Aged
Original
Proteinuria - urine
Remission Induction
Renal Dialysis
Retrospective Studies
Serum Albumin - metabolism
Survival Analysis
Time Factors
Young Adult
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Summary:Idiopathic collapsing FSGS has historically been associated with poor renal outcomes. Minimal clinical data exist on the efficacy of immunosuppressive therapy. Our study sought to provide a comprehensive description of renal survival in patients with collapsing and not otherwise specified FSGS after controlling for factors affecting renal prognosis. We performed a retrospective analysis of an inception cohort study of patients diagnosed between 1989 and 2012. All potential patients with collapsing FSGS fulfilling the inclusion criteria were identified and compared with patients with not otherwise specified FSGS (approximately 1:2 ratio) on the basis of biopsy report and record availability. Time to ESRD was analyzed using Cox proportional hazards models. In total, 187 patients were studied (61 collapsing and 126 not otherwise specified), with a mean follow-up of 96 months. At baseline, patients with collapsing FSGS had higher median proteinuria (12.2 [5.6-14.8] versus 4.4 [2.3-8.1] g/d, respectively;
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.13091215