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Clinical features and outcomes of focal segmental glomerulosclerosis pathologic variants in Korean adult patients

Authors
 Young Eun Kwon  ;  Seung Hyeok Han  ;  Jeong Hae Kie  ;  Seong Yeong An  ;  Yung Ly Kim  ;  Kyoung Sook Park  ;  Ki Heon Nam  ;  Ah Young Leem  ;  Hyung Jung Oh  ;  Jung Tak Park  ;  Tae Ik Chang  ;  Ea Wha Kang  ;  Shin-Wook Kang  ;  Kyu Hun Choi  ;  Beom Jin Lim  ;  Hyeon Joo Jeong  ;  Tae-Hyun Yoo 
Citation
 BMC Nephrology, Vol.15(52) : 1-9, 2014 
Journal Title
 BMC Nephrology 
ISSN
 1471-2369 
Issue Date
2014
Abstract
BACKGROUND: Many studies have shown that clinical characteristics and outcomes differ depending on pathologic variants of focal segmental glomerulosclerosis (FSGS). However, these are not well defined in Asian populations. METHODS: This retrospective study evaluated clinical features and outcomes of pathologic FSGS variants in 111 adult patients between January 2004 and December 2012. Primary outcome was the composite of doubling of baseline serum creatinine concentrations (D-SCr) or onset of end-stage renal disease (ESRD). Secondary outcome included complete (CR) or partial remission (PR). RESULTS: There were 70 (63.1%), 20 (18.0%), 17 (15.3%), 3 (2.7%), and 1 (0.9%) patients with not-otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants, respectively. At presentation, nephrotic-range proteinuria occurred more commonly in tip lesion than in other variants. The overall 5-year renal survival rate was 76.8%. During a median follow-up of 34.5 months, only 1 (5.0%) patient with a tip lesion reached the composite end point compared to 2 (11.8%) and 12 (17.1%) patients in perihilar and NOS variants, but this difference was not statistically significant in an adjusted Cox model. However, tip lesion was associated with a significantly increased probability of achieving CR (P = 0.044). CONCLUSION: Similar to other populations, Korean adult patients with FSGS have distinct clinical features with the exception of a rare frequency of cellular and collapsing variants. Although pathologic variants were not associated with overall outcome, the tip variant exhibited favorable outcome in terms of achieving remission. Further studies are required to delineate long-term outcome and response to treatment of the pathologic variants.
Files in This Item:
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DOI
10.1186/1471-2369-15-52
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
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
강이화(Kang, Ea Wha)
권영은(Kwon, Young Eun)
기정혜(Kie, Jeong Hae)
김영리(Kim, Yung Ly)
남기헌(Nam, Ki Heon) ORCID logo https://orcid.org/0000-0001-7312-7027
박경숙(Park, Kyoung Sook)
박정탁(Park, Jung Tak) ORCID logo https://orcid.org/0000-0002-2325-8982
안성영(An, Seong Yeong)
오형중(Oh, Hyung Jung)
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
임범진(Lim, Beom Jin) ORCID logo https://orcid.org/0000-0003-2856-0133
임아영(Leem, Ah Young) ORCID logo https://orcid.org/0000-0001-5165-3704
장태익(Chang, Tae Ik)
정현주(Jeong, Hyeon Joo) ORCID logo https://orcid.org/0000-0002-9695-1227
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98586
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