An Analysis of Focal Segmental Glomerulosclerosis according to Morphologic Subtypes

ABSTRACT

BACKGROUND: The histological subtypes of focal segmental glomerulosclerosis (FSGS) have different significance and influence clinical presentations and outcomes in patients with FSGS. However, no such data has been reported in Korea. METHODS: We reviewed renal biopsy specimens of 69 adult patients who were diagnosed with idiopathic FSGS between 2000 and 2008, subclassified them according to the Columbia classification and correlated the results with clinical findings. RESULTS: The frequencies of the FSGS subtypes were not otherwise specified (NOS) (n = 28), tip (n = 21), perihilar (n = 11), collapsing (n = 5) and cellular types (n = 4) in descending order. Nephrotic syndrome was more common in patients with the tip and collapsing types than the perihilar type. The prevalence of chronic kidney disease stage 4/5 at the time of renal biopsy was significantly higher in patients with the cellular type than the NOS or the tip type. The remission rate after treatment tended to be higher in patients with the NOS type (22.0%) and the tip type (15.2%) than the perihilar (6.8%) and collapsing types (3.4%). CONCLUSIONS: Classifying FSGS subtypes may be helpful to predict of clinical features and renal outcomes.