Clinical course and outcome of adult patients with primary focal segmental glomerulosclerosis with kidney function loss on presentation

Table 1 Demographic characteristics, clinical features, biochemical and histopathological results of adult patients of focal segmental glomerulosclerosis with kidney function loss at presentation, n = 98

Parameters	Results
Age in years	30.9 ± 13.6
Sex as male:female	2.5:1
Systolic BP in mmHg	132.7 ± 19.8
Diastolic BP in mmHg	87.4 ± 12.7
Initial proteinuria in mg/24 hours	5945.1 ± 4007.9
Serum albumin in g/dL	2.1 ± 1.0
Serum creatinine in mg/dL	2.2 ± 1.3
Renal insufficiency in males	70 (71.4)
Renal insufficiency in females	28 (28.6)
Estimated glomerular filtration rate on presentation in mL/minute/1.73 m2	37.1 ± 12.8
Histopathological findings
Number of glomeruli	16.4 ± 8.2
Number of glomeruli with global sclerosis	3.4 ± 2.9
Number of glomeruli with segmental sclerosis	3.1 ± 3.0
Tubular atrophy
Mild	41 (41.8)
Moderate	11 (11.2)
Fibrointimal thickening of arteries
Mild	9 (4.2)
Moderate	4 (4.1)
Focal segmental glomerulosclerosis variants
Not otherwise specified	43 (43.9)
Tip	20 (20.4)
Collapsing	19 (19.4)
Hilar	1 (1.0)
Cellular	1 (1.0)
Unknown/unclassified	14 (14.3)

Data are n (%). BP: Blood pressure.

Table 2 Treatment responses and follow-up information of adult patients with primary focal segmental glomerulosclerosis with kidney function loss at presentation who received steroid treatment, n = 81

Parameters	Results
Follow-up duration in weeks	136.8 ± 20.6
Total steroid dose in mg	4391.5 ± 1502.4
Duration of steroid treatment in weeks	19.9 ± 14.4
Time to remission in weeks	11.3 ± 6.7
Complete remission	20/81 (24.6)
Partial remission	9/81 (11.1)
No remission	52/81 (64.1)
Spontaneous remission	2 (2.4)

Data are n (%).

Table 3 Comparison of main demographic, clinical, and laboratory parameters among steroid-responsive and non-responsive adult patients with primary focal segmental glomerulosclerosis with kidney function loss at presentation and treated with steroids, n = 81

Parameters	Steroid-responsive group, n = 29	Steroid non-responsive group, n = 52	P value
Age in years	32.9 ± 13.3	38.2 ± 15.2	0.123
Sex as male:female	3.8:1	2.1:1	0.251
Systolic BP in mmHg	132.1 ± 22.2	131.8 ± 18.6	0.946
Diastolic BP in mmHg	84.9 ± 13.2	87.5 ± 12.7	0.380
Initial protein in mg/24 hours	5161.9 ± 3615.2	5803.1 ± 3879.4	0.569
Serum albumin in g/dL	1.87 ± 1.06	2.05 ± 1.01	0.492
Serum creatinine in mg/dL	2.105 ± 1.81	2.20 ± 0.92	0.748
Estimated glomerular filtration rate on presentation in mL/minute/1.73 m2	43.2 ± 11.8	35.5 ± 11.2	0.006
Cumulative steroid dose in mg/kg	34.5 ± 32.1	48.4 ± 37.8	0.097
Duration of steroid use in weeks	22.8 ± 21.7	18.3 ± 7.9	0.180
Histopathological findings
Number of glomeruli	17.25 ± 6.78	16.67 ± 9.32	0.806
Number of glomeruli with global sclerosis	2.55 ± 1.64	3.63 ± 3.89	0.396
Number of glomeruli with segmental sclerosis	2.53 ± 1.64	4.37 ± 3.56	0.057
Tubular atrophy
Mild	5 (100)	4 (66.7)	0.455
Moderate	0 (0)	2 (33.3)
Fibrointimal thickening of arteries
Mild	22 (91.7)	17 (68)	0.074
Moderate	2 (8.3)	8 (32)
Focal segmental glomerulosclerosis variants
Not otherwise specified	15 (51.7)	24 (46.2)	0.012
Tip	11 (37.9)	7 (13.5)
Collapsing	2 (6.9)	15 (28.8)
Hilar	1 (3.4)	0 (0)
Cellular	0 (0)	1 (1.9)
Unknown/unclassified	0 (0)	5 (9.6)

Data are n (%). BP: Blood pressure.

Table 4 Comparison of main clinicopathological parameters and outcomes among the two groups [those with kidney function loss (n = 81) and those with normal kidney function (n = 254) at presentation] of adult focal segmental glomerulosclerosis patients treated with steroids

Parameters	Kidney function loss, n = 81	Normal kidney function, n = 254	P value
Age in years	36.3 ± 14.7	26.5 ± 10.4	< 0.001
Sex as male:female	2.5:1	1.9:1	0.328
Systolic in mmHg	131.9 ± 19.8	128.4 ± 17.9	1.464
Diastolic in mmHg	86.5 ± 12.8	83.9 ± 12.2	1.664
Serum albumin in g/dL	1.9 ± 1.0	1.9 ± 1.1	0.807
Initial proteinuria in mg/24 hours	5626.2 ± 3787	4396.0 ± 2805.2	0.009
Serum creatinine in mg/dL	2.2 ± 1.3	0.8 ± 0.2	< 0.001
Follow-up duration in weeks	136.8 ± 120.6	152.94 ± 115.6	0.243
Total steroid dose in mg	4391.5 ± 1502.3	4279.6 ± 2039.5	0.649
Duration of steroid treatment in weeks	19.90 ± 14.4	23.27 ± 23.9	0.231
Time to remission	11.3 ± 6.7	12.6 ± 20.4	0.705
Number of glomeruli with global sclerosis	3.6 ± 2.9	2.0 ± 1.5	< 0.001
Number of glomeruli with segmental sclerosis	3.2 ± 3.2	2.9 ± 2.6	0.61
Tubular atrophy
Mild	39 (79.6)	133 (90.5)	0.044
Moderate	10 (20.4)	14 (9.5)
Outcomes
Complete remission	20/81 (24.7)	66/254 (25.9)	0.428
Partial remission	9/81 (11.1)	42/254 (16.5)
No remission	52/81 (64.2)	146/254 (57.4)
Doubling of serum creatinine	13/52 (25.0)	16/146 (10.9)	0.007

Data are n (%).