Short term follow up of childhood focal segmental glomerulosclerosis in India

Abstract

Summary: A retrospective analysis of 67 biopsy proven cases of focal segmental glomerulosclerosis (FSGS) in children was performed. After a mean duration of disease of 48.5 ± 44 months, 20 patients (30%) achieved sustained remission (SR), 23 (34%) had frequent relapses (FR) and 24 (36%) were steroid non‐responders (NR). the NR group had a significantly higher mean age of onset 9.1 ± 1.01 years (P= 0.003) and had higher number of females (P= 0.0009). They also had a significantly higher prevalence of microhaematuria as compared to FR and SR groups (P= 0.002). the initial steroid response category (P<0.00001) and the percentage of glomeruli with segmental sclerosis on histopathology (P= 0.001) correlated with the subsequent outcome. During this period six children developed progressive renal failure and all of them belonged to NR group (25%). There were four deaths and all of them were non‐responders (16.6%). Features predictive of a poor therapeutic outcome in childhood FSGS are age of onset more than 9 years, female sex, microhaematuria, renal dysfunction at onset, initial non‐response to steroids and percentage of glomeruli with segmental sclerosis on histopathology.