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논문분류	춘계학술대회 초록집
제목	The clinicopathologic prognostic factors to estimate ESRD in patients with FSGS from national wide cohort of renal biopsy
저자	SO YOUNG JANG
출판정보	2024; 2024(1):
키워드
초록	Objectives: We searched for prognostic markers of any form of FSGS. Methods: We enrolled a total of 20,404 adult patients who underwent native renal biopsy from 1979 to 2018 in 18 hospitals in Korea. We selected patients with definite FSGS patients with proper criteria. We evaluated prognostic factors to estimate the risk of ESRD. Results: During 117.5 ± 100.1 months of follow-up period, there were 97 (19.0%) patients with incident ESRD among 511 selected FSGS patients. Pathologic prognostic factors were glomerular size, amount of global sclerosis and segmental sclerosis, severity of increase in glomerular matrix, interstitial fibrosis, interstitial inflammation, and tubular atrophy, and presence of artherosclerosis of intrarenal vessels. Adjusted with clinicopathologic factors related to incident ESRD, Cox’s proportional hazard models revealed only pathologic findings of amount of glomerular global sclerosis and segmental sclerosis and presence of tubular atrophy were the independent prognostic factors. GFR and UPCR showed significant relationship with incidence of ESRD, however, the significance was gone in the model adjusted with pathologic findings. AUC by ROC to estimate the event of ESRD by percentage of global sclerosis was 0.601 (range; 0.538-0.663, p=0.002) and, by percentage of segmental sclerosis, 0.679 (range; 0.616-0.743, p<0.001). We grouped patients with three pathology categorical variables of a criterion of GS 30.9 %, SS 10.5%, and moderate degree in severity of tubular atrophy , resulted in 8 groups, and summarized into 4 groups according to the relative risk to develop ESRD (FIGURE). UPCR was a significant risk factor to estimate ESRD only in Group 4 with the criterion of 2 g/g creatinine . GFR was not a prognostic factor in any pathology subgroup. Conclusions: Significance of UPCR and GFR as prognostic factors was varied according to pathologic findings. We need to reconsider the criterion of UPCR to initiate immunosuppressive treatment.
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