Abstract: TH-PO163

Improvement of Clinical Outcome in Kidney Diseases via the On-line Thai Glomerular Disease Registry: Focal Segmental Glomerulosclerosis

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Pattanachaiwit, Noppanit, Bhumibol Adulyadej hospital, Bangkok, Thailand
  • Worawichawong, Suchin, Ramathibodi Hospital, Bangkok, Thailand
  • Cheunsuchon, Boonyarit, Siriraj hospital, Bangkok, Thailand
  • Tantranont, Ngoentra, Siriraj hospital, Bangkok, Thailand
  • Pichaiwong, Warangkana, RAJAVITHI HOSPITAL, Bangkok, Thailand
  • Sangthawan, Pornpen, Prince of Songkla University Hospital, Songkhla, Thailand
Background

Focal segmental glomerulosclerosis (FSGS) is one of the most common cause of end stage renal disease (ESRD) in adults. FSGS is more common in African-Americans than Asians. In Thailand, the data of FSGS have not been well determined. This study was conducted to investigate the prevalence and outcomes of FSGS via using the data from the on-line registry from Thai Glomerular Disease Collaborative Network (TGCN).

Methods

The data of biopsy-proven FSGS in adults were collected by the on-line registry from July 2014 to March 2017. Patients’ clinical data including histopathological diagnosis at baseline, and clinical outcomes at 24, 48 and every 48 weeks after renal biopsy were analyzed.

Results

FSGS was diagnosed in 170 patients (10.9%) from 1,556 renal biopsy specimens. At the time of biopsy, 44.2% of FSGS was male, the mean age was 47.5+16.9 years, median serum creatinine level was 1.7 mg/dL (0.42-8.33), median urine protein creatinine ratio (UPCR) was 4.36 g/g.Cr (0.08-25.3), mean serum albumin (sAlb) was 2.8±0.9 g/dL. Nephrotic syndrome was 75%, whilst nephrito-nephrotic syndrome was only 2%. Most common histologic variant was not-otherwise-specified (NOS) (80.7%) followed by tip lesion (10.0%), perihilar variant (3.6%), cellular variant (3.6%), and collapsing FSGS (2.1%). At 24-week follow up, 22.9% of patients had complete remission and 62.7% had partial remission. The median time to all remission was 5.7 months. The only factor that was significantly associated with the remission rate was the percentage of tubular atrophy more than 50% with HR 0.24 (95%CI 0.07-0.81, p = 0.021) Three patients developed ESRD during the period of study.

Conclusion

The prevalence of FSGS in our study was 10.9%. NOS was the most common histologic variant. The severity of tubular atrophy was the only significant poor prognostic factor.
Funding: Health Systems Research Institute, and Nephrology Society of Thailand support

Funding

  • Private Foundation Support