Abstract: TH-PO169
Clinical Features and Outcomes of Collapsing Glomerulopathy
Session Information
- Clinical Glomerular Disorders: FSGS, MN, MCD
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1005 Clinical Glomerular Disorders
Authors
- Figueiredo, Giulia gabriela Borges, University of Sao Paulo, Brazil, São Paulo, Brazil
- Mota, Lucas Braga, University of São Paulo, São Paulo, Brazil
- Soares, Luanne Fortes monte, University of Sao Paulo, Brazil, São Paulo, Brazil
- Neves, Precil D, University of Sao Paulo, Brazil, São Paulo, Brazil
- Miguel, Hady Signara, Univertty of sao Paulo, São Paulo, Brazil
- Testagrossa, Leonardo A., University of São Paulo, São Paulo, Brazil
- Dias, Cristiane B., University of Sao Paulo, Brazil, São Paulo, Brazil
- Yu, Luis, University of Sao Paulo, Brazil, São Paulo, Brazil
- Woronik, Viktoria, None, Salvador, Brazil
- Jorge, Lectícia, University of São Paulo, São Paulo, Brazil
Background
The collapsing variant of focal and segmental glomerulosclerosis (FSGS) has usually been associated with poor renal outcomes. The aim of our study was to evaluate clinical features and renal outcomes associated with collapsing FSGS.
Methods
A retrospective analysis was carried out on all collapsing FSGS diagnosed by kidney biopsy between 1996-2016. Clinical and laboratory data were collected at baseline and at the end of follow up. Primary outcome (PO) was defined as ESRD or doubling of baseline creatinine.
Results
Clinical features are summarized in table 1. The PO occurred in 54.8% of patients. Pathology data analysis showed a higher prevalence of acute tubular necrosis (ATN) in patients who did not achieved PO, 14,3% versus 0%, with a p value of 0.03. The percentage of interstitial fibrosis was similar in both groups.
Conclusion
Collapsing glomerulopathy is an aggressive disease, and patients who reached the PO had greater baseline proteinuria and less partial or complete remission. As baseline creatinine was not a predictor of PO, perhaps the therapy should not be withheld in patients with high creatinine at presentation.
Clinical aspects of Collapsing FSGS patients
| Baseline | With PO | Without PO | |
| Patients | 77 | 34 (54.8%) | 28 (45.2%) |
| Age (Y) | 28.5 (21-38) | 24.5 (21-38) | 23.5 (30-50.5) |
| Male | 43 (55.1%) | 21 (61.8%) | 15 (53.6%) |
| Creatinine (mg/dL) | 1.98 (1.2-3.16) | 1.6 (1.2-2.2)* | 2.2 (1.3-3.7) |
| Proteinuria (g/day) | 5.4 (3.36-10.4) | 8.8 (3.8-13.3)* | 5.0 (3.6-7.9) |
| AKI (n,%) | 47 (68%) | 23 (67%) | 20 (71%) |
| Hematuria | 34 (50%) | 15 (44%) | 14 (50%) |
| Hypertension | 24 (48%) | 11 (52%) | 12 (43%) |
| Albumin (g/dL) | 2.26 ±0.9 | 2.0 ±0.8 | 2.4 ±0.9 |
| Hb (g/dL) | 12.5 ±2.2 | 13.1 ±2.2* | 11.9 ±2.1 |
| Final creatinine (mg/dL) | 2.8 (1.1-8.5) | 8.1 (2.7-12.8)* | 1.2 (0.9-2.3) |
| Final proteinuria (g/day) | 2.8 (0.7-6.16) | 4.4 (2.1-9.8)* | 0.79 (0.36-3.08) |
| Follow up (mo) | 18.5 (7.8-43.8) | 15 (7.3-34.8) | 21 (10-52.3) |
| Corticorsteroid | 36 (70.6%) | 14 (61%) | 22 (78%) |
| Remission† | 28 (47,5%) | 12 (35.3%) | 22 (78.5%) |
Data showed as mean (+/-SD) or median (IQR). * p<0.05 versus without PO. † <3.5g/day of proteinuria.