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Abstract: PO1893

Clinicopathologic Characterization of Focal and Segmental Glomerulosclerosis in a Dominican Republic Sample

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Dina-Batlle, Eliana, Hospital Metropolitano de Santiago, Santiago, Dominican Republic
  • Rojas, Limber Ivan, Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic
  • Almanzar, Mirtha Camila, Hospital Metropolitano de Santiago, Santiago, Dominican Republic
  • Pantaleon, Hector A., Hospital Metropolitano de Santiago, Santiago, Dominican Republic
  • Sánchez, José Javier, Pontificia Universidad Catolica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
Background

There are limited recent epidemiological and clinicopathological behavior reports on FSGS in the Caribbean population. The aim is to identify clinical characteristic, epidemiological trend and treatment response of patients with diagnosed FSGS and their different variants in a Dominican Republic sample

Methods

Cross-sectional study of performed transcutaneous native kidney biopsy taken in an interval date from years 2018-2019 of two separate nephrology consult from Dominican Republic. Diagnosed FSGS biopsy reports availability and biochemical laboratories (creatinine, BUN, 24h Proteinuria, cholesterol, triglycerides, hematuria) within the date of biopsy were analyzed. Histopathological analysis of foot process effacement (FPE) degree reported and nephrotic syndrome (NS) presentation was correlated to primary or secondary cause of FSGS. Also, description of FSGS variants response to the different treatments implemented at the time of data collection, overlapping comorbidities and serology were taken in notice

Results

49 biopsies were analyzed with FSGS. NOS variant was the most common (72%), tip lesion (6%) and collapsing (6%), with no reported perihilar or cellular variants and (16%) reported as unsampled biopsy of FSGS. Biopsy with diffuse FPE (>80%) 24 presented with nephrotic syndrome and 8 did not (p= 0.010). Remission in biopsy with described diffuse foot process effacement (DFPE) with unidentified cause 32% had complete remission (CR) (serum albumin >3.5g/dl or <300 mg/24h protein), 16% had partial remission (PR) (≥50% reduction basal proteinuria, subnephrotic proteinuria), and 20% did not remitted at a ≥ 6 month period (p=0.921). Steroids and calcineurin inhibitors treatment were significantly associated with CR in FSGS with DFPE with unidentified cause (p=0.029, p=0.014 respectively)

Conclusion

Biopsies analyzed in a 2 year period presented NOS as the most common variant while perihilar or cellular variants were not reported. In the sample studied the degree of FPE was associated to NS presentation. The use of steroids and calcineurin inhibitors in suitable patients is significantly associated with remission of disease. The FPE degree on biopsy, clinical manifestations of patients and history represent the best tools for correct diagnose and treatment