Primary Focal Segmental Glomerulosclerosis. Clinical Course, Predictors of Renal Outcome and Treatment

Hideo SHIIKI, Kazuhiro DOHI
2000 Internal medicine (Tokyo. 1992)  
Primary focal segmental glomerulosclerosis (FSGS) is the representative of refractory nephrotic syndrome in both adults and children. Wereview the clinical course and predictors of renal outcome in adult FSGS. Patients resistant to treatment frequently develop end-stage renal disease (ESRD), whereas patients achieving a remission show an excellent outcome. The renal survival rate in Japanese patients is 68.7% in 10 years and 31.4% in 20 years, indicating a better prognosis comparedwith the
more » ... mparedwith the previous studies. Whenclinical and histological features at presentation have been evaluated by multivariate analysis, serum creatinine concentrations (>1.5 mg/dl) and the presence of tubulo-interstitial lesions (>20 % ) are significant positive predictors of progression to ESRD.Wealso discuss treatment for adult FSGS,with emphasis on intensive and prolonged therapy. (Internal Medicine 39: 606-611, 2000)
doi:10.2169/internalmedicine.39.606 fatcat:fkqetqclqfanpmku5uiaewneei