A study on variants of focal segmental glomerulosclerosis and their relationship with various biochemical and demographic parameters in kidney biopsies; a single center study

Abstract

Introduction: Focal segmental glomerulosclerosis (FSGS) is one of the most common glomerular diseases leading to end-stage renal failure. According to Columbia classification, there are five histologic variants for FSGS. Objectives: There is no study about prevalence and clinic-pathological features of its variants up to now in Iran. Patients and Methods: The study was conducted on renal biopsy reports in a laboratory center between 2011- 2015. Of 1108 patients, 234 had FSGS (either secondary or primary). Using light and immunofluorescence microscopies, the diagnosis and the variants of FSGS were determined (according to Columbia classification). Pathological findings like interstitial fibrosis and glomerular sclerosis, para-clinical findings including serum creatinine and proteinuria, and demographic features including gender and age were also recorded. Results: Among 212 patients with primary form of FSGS, 58% were males with the male-to-female ratio of 1.38: The mean age was 38.5± 18.72 years. Classic variant (not otherwise specified; NOS) was the most prevalent variant, comprising 89.1% of all cases. Tip variant comprised of 32.5%, perihilar in 23.1%, collapsing in 0.9%, while cellular was detected in 0.5% of cases. Mean serum creatinine was 1.41± 0.84 mg/dL. Moreover, mean of proteinuria was 2201.8±1134.49 mg/day. Mean interstitial fibrosis/tubular atrophy in the variants were; NOS in 14.9 ±10.87% of cases, Tip; 7.26±11.55% of cases and in perihilar was 10.79±15.75%. Conclusion: Our study indicates that NOS variant of FSGS is a highly prevalent variant in our patients. Among them, the highest proportion of interstitial fibrosis was seen in this variant.

Keywords

• Focal segmental
• glomerulosclerosis
• End-stage renal disease
• Columbia classification