Long-term outcome in children and adults with classic focal segmental glomerulosclerosis

被引:177
作者
Cattran, DC [1 ]
Rao, P [1 ]
机构
[1] Univ Toronto, Dept Med, Toronto, ON, Canada
关键词
focal glomerulosclerosis; long-term outcome; treatment;
D O I
10.1053/ajkd.1998.v32.pm9669427
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
A retrospective study was conducted in 93 patients (55 adults and 38 children) with classical focal segmental glomerulosclerosis drawn from the Toronto Glomerulonephritis Registry. The average follow-up period was 11 years, with a cumulative experience of 1,053 patient-years. Both adults and children were similar in profile at the time of entry, except that the nephrotic syndrome was more common in children (55% of adults v 76% of children; P < 0.05). During evolution of the disease, however, the percentages became very similar with 82% of adults and 89% of children developing nephrotic-range proteinuria. At the last observation point, the outcome of patients (adults v children) was complete remission, 22% versus 42%; end stage renal disease, 42% versus 34%; chronic renal insufficiency, 13% versus 11%; and persisting abnormality, 24% versus 13%. Although there were more children than adults in complete remission, the rate was equal in the treated adults compared with the treated children (44% v 47%). Although optimal duration of steroid therapy cannot be determined by this review, treatment beyond 6 months does not appear to be beneficial. The best guide to prognosis remains complete remission, since long-term renal survival in both age groups with this event was 100%. Those without a complete remission generally progress, although even at 10 years the survival rate is 62% in adults and 58% in children. (C) 1998 by the National Kidney Foundation, Inc.
引用
收藏
页码:72 / 79
页数:8
相关论文
共 28 条
[1]   FOCAL SEGMENTAL GLOMERULOSCLEROSIS WITH IDIOPATHIC NEPHROTIC SYNDROME - 3 TYPES OF CLINICAL-RESPONSE [J].
ARBUS, GS ;
POUCELL, S ;
BACHEYIE, GS ;
BAUMAL, R .
JOURNAL OF PEDIATRICS, 1982, 101 (01) :40-45
[2]  
BANFI G, 1991, CLIN NEPHROL, V36, P53
[3]  
BROWN CB, 1978, CLIN NEPHROL, V10, P51
[4]  
CAMERON JS, 1978, CLIN NEPHROL, V10, P211
[5]  
CATTRAN DC, 1981, CAN MED ASSOC J, V124, P158
[6]  
CHURG J, 1982, FOCAL SEGMENTAL GLOM, P37
[7]  
DILLON JJ, 1995, J AM SOC NEPHROL, V6, P417
[8]   RACIAL-DIFFERENCES IN THE INCIDENCE AND RENAL OUTCOME OF IDIOPATHIC FOCAL SEGMENTAL GLOMERULOSCLEROSIS IN CHILDREN [J].
INGULLI, E ;
TEJANI, A .
PEDIATRIC NEPHROLOGY, 1991, 5 (04) :393-397
[9]  
JANIS EH, 1974, AM J MED, V57, P695
[10]  
KASISKE BI, 1996, KIDNEY, P1162