Kidney Week

Abstract: PUB162

Treatment Response in FSGS with Nephrotic-Range Proteinuria: Decision-Making in the Absence of Electron Microscopy

Session Information

• Publication Only

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Garnica León, Isa Selene, Department of Nephrology, Mexican Institute of Social Security, National Medical Center 21 st Century, Mexico City, Mexico

Isa Selene Garnica León, MD

• Pazos Perez, Fabiola, Department of Nephrology, Mexican Institute of Social Security, National Medical Center 21 st Century, Mexico City, Mexico

Fabiola Pazos Perez, MD, PhD

• Gil-Hernández, Alan Misael, Department of Nephrology, Mexican Institute of Social Security, National Medical Center 21 st Century, Mexico City, Mexico

Alan Misael Gil-Hernández, MD

• García Matías, Armando Omar, Department of Nephrology, Mexican Institute of Social Security, National Medical Center 21 st Century, Mexico City, Mexico

Armando Omar García Matías, PhD

Background

FSGS is a cause of nephrotic syndrome and chronic kidney disease. KDIGO guidelines emphasize distinguishing primary, secondary, and genetic forms because prognosis and treatment differ. Electron microscopy give diagnosis, nephrotic syndrome is commonly used clinically to support primary FSGS and consideration of immunosuppressive therapy.

Methods

A retrospective observational study included 46 adults with biopsy-confirmed FSGS in Mexico during 2023. Clinical, laboratory, and biopsy data were analyzed, focusing on proteinuria, hematuria, histopathological variants, and remission outcomes. Variables were reported using descriptive statistics.

Results

Baseline proteinuria data were available for 46 patients (Table 1). Hematuria was observed only in the subnephrotic group. Immunosuppressive therapy achieved complete remission in 72% of nephrotic and 54% of subnephrotic patients. Tip lesion predominated in nephrotic-range proteinuria, whereas the NOS variant was most frequent in subnephrotic proteinuria (Figure 1, Figure 2).

Conclusion

Subnephrotic proteinuria was more frequent than nephrotic-range proteinuria. Tip lesion predominated in nephrotic cases, whereas the NOS variant was more common in subnephrotic patients and associated with higher remission rates, supporting individualized immunosuppressive therapy.