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성인 원발성 초점성 사구체 경화증의 예후인자

Other Titles
 Prognostic Factor for Adult Primary Focal Segmental Glomerulosclerosis 
Authors
 송영수  ;  최훈영  ;  최규헌  ;  한대석  ;  이호영  ;  정현주  ;  이중민  ;  강신욱  ;  유태현 
Citation
 Korean Journal of Nephrology (대한신장학회지), Vol.23(1) : 36-45, 2004 
Journal Title
 Korean Journal of Nephrology (대한신장학회지) 
ISSN
 1225-0015 
Issue Date
2004
Keywords
Adult primary focal segmental glomerulosclerosis ; Prognostic factor
Abstract
Background : Primary focal segmental glomerulosclerosis (FSGS) is a cause of nephrotic syndrome in adult. Although primary FSGS has been known to be refractory to treatment, recent studies reveal higher remission rate and better prognosis. And it has been reported that some clinical and histopathologic paramenters are significant to prognosis. But, confirmative prognostic indices remain to be defined. In order to further clarify the prognostic factors for therapeutic response and risk factors for progression to chronic renal failure (CRF), we reviewed the medical records of primary adult FSGS patients. Methods : Forty-adult patients diagnosed as primary FSGS between 1991 to 2002 were enrolled. We retrospectively analyzed the clinical and histopathological parameters of all patinents at the time of renal biopsy. In addition, the therapeutic responses to immunosuppressants and the renal survival were analyzed. Results : At the time of renal biopsy, 26 patients (65%) had proteinuria of the nephrotic range and 14 patients (35%) had proteinuria of the non-nephrotic range. The serum creatinine level was higher in nephrotic-ranged patients than that in non nephroticranged patients (p<0.05). The other parameters were not significantly different between two groups. Twenty-seven patients were treated with immunosuppressants and 15 patients (55.6%) responded to the treatment. There was no significant difference in clinical or histopathological variables between the responders and the non-responders. High serum creatinine level at diagnosis and responsiveness to treatment appeared to be significant as risk factors for progression to CRF (p<0.05). The paticnts treated with immunosuppressants had longer survival period, compared with those without treatment. And the responders had significantly longer survival period compared with the non-responders (p<0.05). Conclusion : The patients with initial impairment of renal function or poor response to therapy may have worse prognosis, and the intense treatment with regular follow-up of renal function should be recommended for these patients.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Song, Young Soo(송영수)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Jung Min(이중민)
Lee, Ho Yung(이호영)
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
Han, Dae Suk(한대석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/112044
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