Published in:
01-07-2006 | Original Article
Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis
Authors:
Marcelo M. Abrantes, Luis Sergio B. Cardoso, Eleonora M. Lima, José M. Penido Silva, José S. Diniz, Eduardo A. Bambirra, Eduardo A. Oliveira
Published in:
Pediatric Nephrology
|
Issue 7/2006
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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.