ISSN:
1432-198X
Keywords:
Key words Focal segmental glomerulosclerosis
;
Nephrotic syndrome
;
Renal failure
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Glomerular diseases in children, although similar in histological appearance to those in adults, may have a better prognosis. There is much controversy regarding the prognostic factors in idiopathic focal segmental glomerulosclerosis (FSGS), especially the comparative prognosis of children and adults. A comparative analysis was carried out of 36 consecutive biopsy-proven cases of idiopathic FSGS presenting early in life [’early onset’ as seen in children ≤12 years (group I)] and 36 cases presenting later [’late-onset’ as seen in older children 〉12 years and adults (group II)]. Patients were compared for clinical, biochemical, and histopathological features, as well as disease outcome. A significantly higher prevalence of hypertension (P=0.002) and microscopic hematuria was seen in group II (P=0.02). There were no differences between the two groups in glomerular filtration rates corrected for body surface area at initial presentation (92±11 ml/min/1.73 m2 vs. 94±14 ml/min/1.73 m2). Patients with ’late-onset’ FSGS had a significantly higher number of glomeruli with segmental sclerosis (P=0.007), more mesangial matrix expansion (P=0.009), greater mesangial cellularity (P=0.003), and significantly higher blood vessel involvement (P=0.03) than those with ’early onset’ FSGS. There was a significantly higher response to steroids in group I (82.3%) than group II (36.4%) (P〈0.02). At the end of the study period, 2 patients in group I and 11 in group II had developed persistent renal failure (P=0.01). Thus ’early onset’ FSGS is more common in males, has significantly lower prevalence of hypertension and microscopic hematuria, with less-severe histopathological involvement, is more often steroid responsive, and has a better prognosis than ’late-onset’ FSGS.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/PL00013419
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