Retrospective analysis of clinical data and treatment of primary focal segmental glomerulosclerosis patients

  • Fabiana Department of Internal Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Ebru Gök Oguz Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara
  • Ozlem Yayar Department of Nephrology, Manisa State Hospital, Manisa, Turkey
  • Hatice Sahin Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Mehmet Deniz Aylı Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
Keywords: primary focal segmental glomerulosclerosis; immunosuppression; corticosteroid; calcineurin inhibitor; remission; proteinuria

Abstract

Introduction: The aim of the study is to compare clinical data of primary focal segmental glomerulosclerosis patients with other data in the literature. In addition, initial immunosuppressive therapy (steroid, calcineurin inhibitors) responses are aimed to be compared with the results in the literature. Methods: Forty seven patients, who were followed up for at least 12 months with primary focal segmental glomerulosclerosis as a result of kidney biopsy. Results of biochemical tests and treatment modalities were evaluated. Results: The mean age of the 47 patients with primary focal segmental glomerulosclerosis was 45.68 (± 13.92). Twenty-one (44.6 %) of 47 patients had an angiotensin converting enzyme inhibitor/angiotensin receptor blocker, 7 (14.8 %) had only corticosteroids, and 6 (12. 7%) had calcineurin inhibitor + low-dose corticosteroids treatment. Thirteen patients (27.6 %) used calcineurin inhibitor + low-dose corticosteroids after receiving corticosteroids treatment. The patients who received corticosteroids or calcineurin inhibitor + low-dose corticosteroids treatment as the initial treatment were compared at the 0,6 and 12 months of treatment in terms of laboratory and clinical features. At the end of the first year, 4 out of 6 (66 %) patients with low-dose corticosteroids and calcineurin inhibitor and 6 out of  (86 %) of 7 patients with corticosteroids had remission (p>0.05). Conclusion: We found the initial steroid treatment and calcineurin inhibitor treatment to be equally effective. We thought that patients with steroid intolerance could be given calcineurin inhibitor in the first step, but if the cost is considered, the first option, such as the Kidney Disease Improving Global Outcomes recommendation, was again steroid. 

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Published
2020-08-06
How to Cite
1.
Fabiana, Gök Oguz E, Yayar O, Sahin H, Deniz Aylı M. Retrospective analysis of clinical data and treatment of primary focal segmental glomerulosclerosis patients. Rev Nefrol Dial Traspl. [Internet]. 2020Aug.6 [cited 2024Jul.16];39(4):249-62. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/495
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Original Article