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Journal of the Korean Society of Pediatric Nephrology 2001;5(2): 125-135.
소아 국소성 분절성 사구체 경화증에서의 장기예후인자 분석
김은아, 이영목, 김지홍, 이재승, 김병길, 정현주
1연세대학교 의과대학 소아과학교실, 신장질환연구소
2연세대학교 의과대학 소아과학교실, 신장질환연구소
3연세대학교 의과대학 소아과학교실, 신장질환연구소
4연세대학교 의과대학 소아과학교실, 신장질환연구소
5연세대학교 의과대학 소아과학교실, 신장질환연구소
6연세대학교 의과대학 병리학교실, 신장질환연구소
Long-term Prognostic Factors in Pediatric Focal Segmental Glomerulosclerosis
Eun A Kim, Young-Mock Lee, Ji Hong Kim, Jae Seung Lee, Pyung-Kil Kim, Hyun Joo Jung
1Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine
2Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine
3Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine
4Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine
5Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine
6Department of Pathology, The Institute of Kidney Disease, Yonsei University College of Medicine
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ABSTRACT
Purpose : Efforts to predict long-term outcome of focal segmental glomerulosclerosis(FSCS) have been made but have yielded conflicting results. Reports are rare especially in Pediatric patients. In this study, we reviewed the predictable prognostic factors in patients of FSGS Method : Fifty children who diagnosed as biopsy-proven FSGS at department of pediatrics at Yonsei university were studied retrospectively. Based on medical records, response to treatment and pathologic slides, we compared normal renal function group and decreased renal function group, assessed the factors affecting renal survival and progression to renal failure.
Results : The mean age at onset was 8 1/12 years, sex ratio was 2.3 : 1, and the mean duration of follow-up was 7 1/12 years. The overall renal survival rate was $34%$ at 5 years, $8%$ at 10 years Five-year survival rate was $74%$ in normal renal function group and $27%$ in decreased renal function group. Between the two groups, there were no significant differences in age at onset, sex ratio, amount of proteinuria, incidence of hematuria and hypertension, mesangial hypercellularity. Decreased renal function group showed higher serum creatinine level, poor response to treatment, higher percent of glomeruli with sclerosis, moderate to severe tubulointerstitial change and vascular change(P<0.05). The prognostic factors of renal survival rate were same as above and incidence of hypertension also affected renal survival( P<0.05). The progression rate to renal failure did not show statistically significant factor.
Conclusion : We reviewed the factors affecting long-term outcome of FSGS. Serum creatinine level, steroid responsiveness, and the degree of glomerulosclerosis were significant prognostic factors. (J Korean Soc Pediatr Nephrol 2001 ;5 : 125-35)
Key words: FSGS | Renal failure | renal survival | Long-term prognosis
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