Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 18;19(12):e0315124.
doi: 10.1371/journal.pone.0315124. eCollection 2024.

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

Smaragdi Marinaki  1 , Panagiotis Kompotiatis  1 , Ioannis Michelakis  1 , Maria Stangou  2 , Aikaterini Papagianni  2 , Maria Koukoulaki  3 , Synodi Zerbala  3 , Dimitrios Xydakis  4 , Nikolaos Kaperonis  5 , Evangelia Dounousi  6 , Spyridon Golfinopoulos  7 , Ioannis Stefanidis  7 , Aggeliki Paikopoulou  8 , George Moustakas  9 , Kostas Stylianou  10 , Ioannis Tzanakis  11 , Marios Papasotiriou  12 , Dimitrios Goumenos  12 , Aimilios Andrikos  13 , Pelagia Kriki  14 , Stylianos Panagoutsos  14 , Eva Kiousi  15 , Eirini Grapsa  15 , Georgios Koutroumpas  16 , Panagiotis Pateinakis  17 , Dorothea Papadopoulou  17 , Vasilios Liakopoulos  18 , Dimitra Bacharaki  19 , Penelope Kouki  20 , Dimitrios Petras  20 , Gerasimos Bamichas  21 , Ioannis Boletis  1
Affiliations

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

Smaragdi Marinaki et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study population.
(Abbreviations: FSGS: Focal Segmental Glomerulosclerosis).
Fig 2
Fig 2. Kaplan-Meier curve.
Survival from renal failure in patients with complete (CR), partial (PR), and no remission (NR).
See this image and copyright information in PMC

References

    1. Haas M, Meehan SM, Karrison TG, Spargo BH. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976–1979 and 1995–1997. Am J Kidney Dis. 1997;30(5):621–31. doi: 10.1016/s0272-6386(97)90485-6 - DOI - PubMed
    1. De Vriese AS, Sethi S, Nath KA, Glassock RJ, Fervenza FC. Differentiating Primary, Genetic, and Secondary FSGS in Adults: A Clinicopathologic Approach. J Am Soc Nephrol. 2018;29(3):759–74. doi: 10.1681/ASN.2017090958 - DOI - PMC - PubMed
    1. Braden GL, Mulhern JG, O’Shea MH, Nash SV, Ucci AA Jr., Germain MJ. Changing incidence of glomerular diseases in adults. Am J Kidney Dis. 2000;35(5):878–83. doi: 10.1016/s0272-6386(00)70258-7 - DOI - PubMed
    1. Hommos MS, De Vriese AS, Alexander MP, Sethi S, Vaughan L, Zand L, et al.. The Incidence of Primary vs Secondary Focal Segmental Glomerulosclerosis: A Clinicopathologic Study. Mayo Clin Proc. 2017;92(12):1772–81. doi: 10.1016/j.mayocp.2017.09.011 - DOI - PMC - PubMed
    1. Kachurina N, Chung CF, Benderoff E, Babayeva S, Bitzan M, Goodyer P, et al.. Novel unbiased assay for circulating podocyte-toxic factors associated with recurrent focal segmental glomerulosclerosis. Am J Physiol Renal Physiol. 2016;310(10):F1148–56. doi: 10.1152/ajprenal.00349.2015 - DOI - PubMed

Substances