The predictive role of histopathological findings in renal insufficiency and complete remission in a sample of Iranian adults with primary focal segmental glomerulosclerosis

Primary focal segmental glomerulosclerosis (FSGS) is defined by the presence of proteinuria, often innephrotic range and pathologically by segmental scars (SS). The aim of this study is to identify the possible predictorsof complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis.METHODS: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed bysingle renal pathologist without knowing about patients identities or outcomes. Patients were divided based on theirhistopathological findings and outcomes were compared among these groups.RESULTS: There were significant differences in the complete remission rate in subjects with and without mesangial hypercellularity(p 0.05), and in patients with and without hyalinosis (p 0.05). According to the cut off points based onROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patientswith and without global scars more than 12% (p 0.05). Also multiple logistic regression analysis strongly suggests theassociation of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency,respectively.CONCLUSIONS: In the studied patients, presence of mesangial hypercellularity and hyalinosis has been suggested asprognostic factors for lower remission rate. According to multivariate analysis, only mesangial hypercellularity andglobal scar were found to act as independent prognostic predictors of lower complete remission rate and progression torenal insufficiency in patients with FSGS, respectively.