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Pediatric Nephrology

, Volume 21, Issue 7, pp 1003–1012 | Cite as

Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis

  • Marcelo M. Abrantes
  • Luis Sergio B. Cardoso
  • Eleonora M. Lima
  • José M. Penido Silva
  • José S. Diniz
  • Eduardo A. Bambirra
  • Eduardo A. OliveiraEmail author
Original Article

Abstract

Renal histological features of focal segmental glomerulosclerosis (FSGS) are found in 75% of pediatric patients with steroid-resistant nephrotic syndrome. In order to evaluate the predictive factors of chronic kidney disease (CKD), we retrospectively reviewed the records of 110 children with biopsy-proven FSGS admitted between 1972 and 2004. Renal survival was analyzed by the Kaplan–Meier method and Cox’s regression model. Two multivariate models were developed: (1) from the onset of symptoms to the occurrence of CKD and (2) from the time of renal biopsy to CKD. Mean follow-up time was 10 years [standard deviation ((SD) 5.5], and 24 patients (21.8%) progressed to CKD. At baseline, after adjustment three variables remained as independent predictors of CKD: age >6.5 years (RR=3.3, 95% CI=1.3–7.8), creatinine >1 mg/dl (RR=2.5, 95% CI=0.97–6.5), and non-response to steroids (RR=7.3, 95% CI=2.7–19.7). In a model with continuous variables only age and non-response to steroids were associated with CKD. At the time of renal biopsy, after adjustment two variables remained as independent predictors of CKD: hematuria (RR=3.0, 95% CI=1.2–7.3) and creatinine >0.8 mg/dl (RR=4.3, 95% CI=1.7–10.6). In a model with continuous variables four factors predicted CKD: age, creatinine, hematuria, and percentage of global sclerosis.

Keywords

Focal segmental glomerulosclerosis Nephrotic syndrome Chronic kidney disease Outcome Survival analysis 

Notes

Acknowledgments

This study was partially supported by CNPq (Brazilian National Research Council), Pró-Reitoria de Pesquisa (UFMG), and FAPEMIG.

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Marcelo M. Abrantes
    • 1
  • Luis Sergio B. Cardoso
    • 1
  • Eleonora M. Lima
    • 1
  • José M. Penido Silva
    • 1
  • José S. Diniz
    • 1
  • Eduardo A. Bambirra
    • 2
  • Eduardo A. Oliveira
    • 1
    • 3
    Email author
  1. 1.Pediatric Nephrourology Unit, Hospital das Clínicas, School of MedicineFederal University of Minas GeraisBelo HorizonteBrazil
  2. 2.Pathology Department, Hospital das Clínicas, School of MedicineFederal University of Minas GeraisBelo HorizonteBrazil
  3. 3.Rua Engenheiro Amaro Lanari 389 / 501Belo HorizonteBrazil

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