Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Tue, Sep 24, 2024
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Volume 15, Issue 3 (Summer 2024)
Caspian J Intern Med 2024, 15(3): 519-526 |
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Pakfetrat M, Malekmakan L, Rezazadeh M H, Tadayon T, Bahmani M, Nikoo A. Five-Year study on renal outcomes in biopsy-proven focal segmental glomerulosclerosis patients in Shiraz, Iran. Caspian J Intern Med 2024; 15 (3) :519-526
URL: http://caspjim.com/article-1-3900-en.html
URL: http://caspjim.com/article-1-3900-en.html
Maryam Pakfetrat 
, Leila Malekmakan * , Mohammad Hosein Rezazadeh , Taraneh Tadayon , Maryam Bahmani , Amirali Nikoo
, Leila Malekmakan * , Mohammad Hosein Rezazadeh , Taraneh Tadayon , Maryam Bahmani , Amirali Nikoo
Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran , malekmakan_l@yahoo.com
Abstract: (673 Views)
Background: Focal segmental glomerulosclerosis (FSGS) is a prevalent glomerular disease that often leads to nephrotic syndrome. It is characterized by consolidating a portion of the glomerular capillary tuft connected to Bowman's capsule. This retrospective cohort study aimed to determine the demographic characteristics, risk factors, and prognostic indicators associated with FSGS in Shiraz, Iran.
Methods: The study included 53 primary FSGS patients aged over 18 years who were referred to clinics affiliated with Shiraz University of Medical Sciences. Data were collected through a comprehensive data-gathering sheet encompassing demographic information, medical history, laboratory test results, and histopathological findings. Statistical analysis was performed using SPSS 18, considering a significance level of p<0.05.
Results: A five-year follow-up was conducted on the 53 patients, with the mean age of 41.0±13.3 years. The most common FSGS variants observed were "not otherwise specified" (NOS, 13.2%) and tip variant (7.5%). Older patients exhibited higher disease activity, whereas remission rates were higher among younger individuals (P=0.012). Patients achieving remission had lower creatinine and Pro/Cr ratios and higher glomerular filtration rates (p<0.05). Treatment involving a combination of corticosteroids and mycophenolate mofetil showed a significant correlation with remission (P=0.036).
Conclusion: Older patients with higher creatinine levels, higher Pro/Cr ratios, and lower glomerular filtration rates at disease onset may require more aggressive treatment. Combination therapy with mycophenolate mofetil and corticosteroids yields better outcomes, leading to increased remission rates. These findings provide valuable insights for managing FSGS patients.
Methods: The study included 53 primary FSGS patients aged over 18 years who were referred to clinics affiliated with Shiraz University of Medical Sciences. Data were collected through a comprehensive data-gathering sheet encompassing demographic information, medical history, laboratory test results, and histopathological findings. Statistical analysis was performed using SPSS 18, considering a significance level of p<0.05.
Results: A five-year follow-up was conducted on the 53 patients, with the mean age of 41.0±13.3 years. The most common FSGS variants observed were "not otherwise specified" (NOS, 13.2%) and tip variant (7.5%). Older patients exhibited higher disease activity, whereas remission rates were higher among younger individuals (P=0.012). Patients achieving remission had lower creatinine and Pro/Cr ratios and higher glomerular filtration rates (p<0.05). Treatment involving a combination of corticosteroids and mycophenolate mofetil showed a significant correlation with remission (P=0.036).
Conclusion: Older patients with higher creatinine levels, higher Pro/Cr ratios, and lower glomerular filtration rates at disease onset may require more aggressive treatment. Combination therapy with mycophenolate mofetil and corticosteroids yields better outcomes, leading to increased remission rates. These findings provide valuable insights for managing FSGS patients.
Keywords: Focal segmental glomerulosclerosis, Nephrotic syndrome, glomerular filtration rate, chronic kidney disease
Type of Study: Original Article |
Subject:
Nephrology
Received: 2023/03/31 | Accepted: 2024/05/12 | Published: 2024/05/12
Received: 2023/03/31 | Accepted: 2024/05/12 | Published: 2024/05/12
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