Caracterización y tratamiento de los pacientes adultos con glomeruloesclerosis focal y segmentaria.

Abstract

Introduction: Glomerulopathies constitute the third cause of chronic kidney disease. Within these, focal segmental glomerulosclerosis (FSGS) is one of the most prevalent in Latin America. Each patient has a varied clinical presentation and etiology, as well as different treatments and evolution. The study aimed to characterize patients with histological diagnosis of FSGS based on their clinical presentation, evolution, and treatment in three public nephrology reference hospitals in Quito-Ecuador. Methods: The present observational, longitudinal, retrospective study was conducted from January 2012 to December 2020 at the Hospitals Carlos Andrade Marín, Eugenio Espejo, and Hospital de las Fuerzas Armadas N1. The variables were demographic, clinical, laboratory, and treatment. Descriptive statistics, proportions, and confidence intervals for a proportion are used. A follow-up of 6, 12, and 24 months was carried out. Results: 98 FSGS records were analyzed, constituting 15.2% of all kidney pathologies. This pathology was more frequent in men (60.2%) and Hispanics (98%), with a median age of 40. 95.9% and 67.3% of the patients had no history of diabetes or hypertension, respectively. The main symptom at diagnosis was non-nephrotic proteinuria (65.3%), and 7.1% of patients required dialysis at the onset of the disease. At six months, only 24% of patients achieved remission. The most common first-line treatments were corticosteroids, followed by mycophenolate, while the most frequently used second-line drug was cyclosporine.