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Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis

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.

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Acknowledgments

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

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Correspondence to Eduardo A. Oliveira.

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Abrantes, M.M., Cardoso, L.S.B., Lima, E.M. et al. Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis. Pediatr Nephrol 21, 1003–1012 (2006). https://doi.org/10.1007/s00467-006-0138-y

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  • DOI: https://doi.org/10.1007/s00467-006-0138-y

Keywords

  • Focal segmental glomerulosclerosis
  • Nephrotic syndrome
  • Chronic kidney disease
  • Outcome
  • Survival analysis