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The Predictive Role of Histopathological Findings in Renal Insufficiency and Complete Remission in a Sample of Iranian Adults With Primary Focal Segmental Glomerulosclerosis



Taheri D1 ; Chehrei A2 ; Samanianpour P3 ; Sadrarhami S3 ; Keshteli AH3, 4 ; Shahidi S5
Authors
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Authors Affiliations
  1. 1. Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. School of Medicine, Arak University of Medical Sciences, Arak, Iran
  3. 3. Medical Students Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Vice Chancellery for Research, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Division of Nephrology, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2010

Abstract

BACKGROUND: Primary focal segmental glomerulosclerosis (FSGS) is defined by the presence of proteinuria, often in nephrotic range and pathologically by segmental scars (SS). The aim of this study is to identify the possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis. METHODS: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patients' identities or outcomes. Patients were divided based on their histopathological findings and outcomes were compared among these groups. RESULTS: There were significant differences in the complete remission rate in subjects with and without mesangial hypercellularity (p < 0.05), and in patients with and without hyalinosis (p < 0.05). According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p < 0.05). Also multiple logistic regression analysis strongly suggests the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively. CONCLUSIONS: In the studied patients, presence of mesangial hypercellularity and hyalinosis has been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only mesangial hypercellularity and global scar were found to act as independent prognostic predictors of lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.
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