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Abstract: PO1529

Natural History of Focal Segmental Glomerulosclerosis (FSGS): The UK National RaDaR Idiopathic Nephrotic Syndrome Cohort

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials


  • Saleem, Moin, University of Bristol, Bristol, Bristol, United Kingdom
  • Barratt, Jonathan, University of Leicester, Leicester, Leicestershire, United Kingdom
  • Braddon, Fiona E. M., UK Renal Registry, Bristol, Bristol, United Kingdom
  • Carroll, Kevin, KLC Statistics Ltd, Cheshire, England, United Kingdom
  • Diva, Ulysses A., Travere Therapeutics Inc, San Diego, California, United States
  • Afzal, Maryam, University of Bristol, Bristol, Bristol, United Kingdom
  • Hendry, Bruce M., Travere Therapeutics Inc, San Diego, California, United States
  • Mercer, Alex, JAMCO Pharma Consulting, Stockholm, Sweden
  • Pitcher, David, UK Renal Registry, Bristol, Bristol, United Kingdom
  • Steenkamp, Retha D., UK Renal Registry, Bristol, Bristol, United Kingdom
  • Turner, A. Neil, University of Edinburgh, Edinburgh, Edinburgh, United Kingdom
  • Gale, Daniel P., Royal Free Hospital, London, London, United Kingdom

Idiopathic FSGS is an important cause of proteinuric renal disease leading to ESKD. Here we describe the natural history of FSGS using the UK National Registry of Rare Kidney Diseases Idiopathic Nephrotic Syndrome (RaDaR-INS) Cohort, including retrospective and prospective data from 3907 patients with nephrotic syndrome (NS) not attributable to glomerulonephritis or systemic disorders recruited from 107 adult and paediatric kidney units across the UK since 2010.


Participants included those with biopsy-proven or monogenic FSGS and ≥12 mo. observation from baseline. Patients with ESKD (CKD stage 5 or on renal replacement therapy) at or prior to baseline were excluded. Baseline date was defined as first database occurrence of renal biopsy, primary renal diagnosis, NS symptoms, PCR ≥1 g/g, or initiation of immunosuppression. Renal survival was defined as absence of ESKD or death with survival time calculated from baseline to last follow-up.


Of 786 FSGS patients meeting eligibility, median baseline age was 28 yrs (IQR 9-49) with paediatric patients representing 38% of the study population. Median proteinuria at baseline was 5.9 g/g (IQR 3.3-11.0; n=140), while mean eGFR was 163 mL/min/1.73m2 (SD 47; n=69) and 71 mL/min/1.73m2 (SD 32; n=103) for children and adults, respectively. Median follow-up duration was 9.7 yrs (IQR 5.7-16.1) with ESKD/death events occurring in 46% of patients (1% death). Kaplan-Meier survival curves of children and adults show 50% renal survival probability of 16 years & 12 years, respectively (Figure 1).


The RaDaR-INS Cohort represents a large study population with lengthy follow-up data. These analyses indicate rapid progression and poor outcomes, highlighting a need for effective treatments for patients with FSGS.


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