CLINICAL COURSE AND OUTCOME OF ADULT PATIENTS WITH PRIMARY FOCAL SEGMENTAL GLOMERULOSCLEROSIS WITH KIDNEY FUNCTION LOSS ON PRESENTATION

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-2195, Poster Board= SAT-118

Introduction:

Kidney function loss, indicated by elevated creatinine levels and an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² at presentation in patients with primary focal segmental glomerulosclerosis (FSGS), is commonly seen as a poor prognostic marker for kidney survival. However, a previous study from our center suggested this may be due to hemodynamic factors.

This study aimed to observe the clinical and biochemical parameters, treatment response, kidney survival, and overall outcomes of adult patients with primary FSGS presenting with reduced kidney function.

Methods:

This study was conducted at the Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan, from January 1995 to December 2017. A total of 401 biopsy-proven primary FSGS patients were enrolled, of which 98 (24.4%) presented with kidney function loss, defined as serum creatinine >1.4 mg/dL in males and >1.2 mg/dL in females.

Results:

Among the 98 patients with elevated serum creatinine, the mean age was 30.9 ± 13.6 years with a male-to-female ratio of 2.5:1. The mean 24-hour urinary protein excretion was 5.9 ± 4.0 g/day, and the mean serum albumin was 2.1 ± 1.0 g/dL (median: 1.5 g/dL). The mean systolic blood pressure (BP) was 132.7 ± 19.8 mmHg, and the mean diastolic BP was 87.4 ± 12.7 mmHg. Steroid treatment was given to 81 (82.6%) of patients for an average duration of 19.9 ± 14.4 weeks, with a mean total steroid dose of 4.4 ± 1.5 gm. Treatment response showed that 20 (24.6%) achieved complete remission, 9 (11.1%) had partial remission, and 52 (64.1%) did not respond. The baseline eGFR was significantly lower in the non-responsive group (p = 0.006). However, further analysis based on the degree of serum creatinine increase at baseline revealed no significant difference in treatment response or outcomes.

Figure 1

Conclusions:

Elevated serum creatinine in FSGS patients at presentation does not necessarily indicate irreversible kidney function loss and may respond to appropriate treatment of the underlying disease.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.