title: Clinical features and outcomes of focal segmental glomerulosclerosis pathologic variants in Korean adult patients.
abstract: BACKGROUND
  Many studies have shown that clinical characteristics and outcomes differ depending on pathologic variants of focal segmental glomerulosclerosis (FSGS). However, these are not well defined in Asian populations.
  
  
  METHODS
  This retrospective study evaluated clinical features and outcomes of pathologic FSGS variants in 111 adult patients between January 2004 and December 2012. Primary outcome was the composite of doubling of baseline serum creatinine concentrations (D-SCr) or onset of end-stage renal disease (ESRD). Secondary outcome included complete (CR) or partial remission (PR).
  
  
  RESULTS
  There were 70 (63.1%), 20 (18.0%), 17 (15.3%), 3 (2.7%), and 1 (0.9%) patients with not-otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants, respectively. At presentation, nephrotic-range proteinuria occurred more commonly in tip lesion than in other variants. The overall 5-year renal survival rate was 76.8%. During a median follow-up of 34.5 months, only 1 (5.0%) patient with a tip lesion reached the composite end point compared to 2 (11.8%) and 12 (17.1%) patients in perihilar and NOS variants, but this difference was not statistically significant in an adjusted Cox model. However, tip lesion was associated with a significantly increased probability of achieving CR (P = 0.044).
  
  
  CONCLUSIONS
  Similar to other populations, Korean adult patients with FSGS have distinct clinical features with the exception of a rare frequency of cellular and collapsing variants. Although pathologic variants were not associated with overall outcome, the tip variant exhibited favorable outcome in terms of achieving remission. Further studies are required to delineate long-term outcome and response to treatment of the pathologic variants.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Kwon
authors.forename: Seung Hyeok
authors.initials: SH
authors.lastname: Han
authors.forename: Jeong Hae
authors.initials: JH
authors.lastname: Kie
authors.forename: Seong Yeong
authors.initials: SY
authors.lastname: An
authors.forename: Yung Ly
authors.initials: YL
authors.lastname: Kim
authors.forename: Kyoung Sook
authors.initials: KS
authors.lastname: Park
authors.forename: Ki Heon
authors.initials: KH
authors.lastname: Nam
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Leem
authors.forename: Hyung Jung
authors.initials: HJ
authors.lastname: Oh
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.forename: Tae Ik
authors.initials: TI
authors.lastname: Chang
authors.forename: Ea Wha
authors.initials: EW
authors.lastname: Kang
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Kyu Hun
authors.initials: KH
authors.lastname: Choi
authors.forename: Beom Jin
authors.initials: BJ
authors.lastname: Lim
authors.forename: Hyeon Joo
authors.initials: HJ
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-Gu, Seoul 120-752, Korea. yoosy0316@yuhs.ac.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
mesh_terms: D017668:Age of Onset; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003404:Creatinine / Q000097:blood*; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine