대한신장학회

논문분류	춘계학술대회 초록집
제목	Immunosuppression Response and Relapse among a Diverse Cohort of Adults with Primary Focal Segmental Glomerulosclerosis (FSGS) in the United States
저자	John Sim
출판정보	2024; 2024(1):
키워드
초록	Objectives: FSGS is associated with variation(s) in treatment patterns and outcomes, with remission rates between 40-70%. The heterogeneity of FSGS contributes to these variations due to different etiologies. We summarize treatment and response rates among a diverse real-world population of patients with biopsy-proven primary FSGS. Methods: A retrospective cohort study within Kaiser Permanente Southern California was performed among patients (age≥18yrs) with biopsy-proven primary FSGS (2010-2021). Primary FSGS was defined as the principal pathology diagnosis AND electron microscopy demonstrating podocyte foot process effacement ≥80%. Treatment index was defined as immunosuppression initiation within 4-weeks prior to and up to 1-year following biopsy. Baseline characteristics were measured during the 1-year prior to index. Treatment response at 8 months was categorized as complete remission (CR; urine protein to creatinine ratio [UPCR]<0.3g/g) or partial remission (PR; UPCR decline of >50% from baseline and between 0.3-3.5g/g). Relapse was defined as any measure outside the CR and PR criteria within 2-years from remission. Multivariate cox regressions were used to estimate hazard ratios (HR) for treatment response. Results: Among 528 patients with primary FSGS, 280 (53%) received immunosuppression. After exclusion criteria (Figure1), 230 patients comprised the study cohort with 209 (91%) receiving corticosteroids. The mean age of the treated cohort was 57.5 years (SD18.3), with 53.9% males, 29.6% Hispanic/Latino, 32.6% White, 20.0% Asian/Pacific Islander, and 17.0% Black patients. Mean eGFR was 46.5 (SD28.6) mL/min/1.73m2 and median UPCR (IQR) was 5.5 (3.8-8.8) g/g. Overall, 125(54.3%) patients achieved remission (98PR and 27CR). Adjusted HR (95% CI) for remission: hyperlipidemia 0.47(0.31-0.73), black race 0.51(0.28-0.93), older age 1.13(1.00, 1.28) and baseline eGFR>60ml/min/1.73m2 1.96(1.15, 3.34). Within 2-years of PR or CR, 90(72%) patients relapsed. Conclusions: Among adult primary FSGS patients, 53% were treated with immunosuppression, with moderate (54%) response rate, and 72% of responders relapsed within 2-years after achieving remission highlighting an unmet need in primary FSGS.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정