A Study of Focal and Segmental Glomerulosclerosis according to the Columbia Classification and Its Correlation with the Clinical Outcome.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-09-01 DOI:10.1055/s-0043-1761930
Swapna Nuguri, Meenakshi Swain, Michelle de Padua, Swarnalata Gowrishankar
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Abstract

Introduction  Focal and segmental glomerulosclerosis (FSGS) is a leading cause of nephrotic syndrome in both adults and children. The "Columbia classification of FSGS" includes five variants; not otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants that may have different prognostic and therapeutic implications. Materials and Methods  This is a retrospective study and was carried out in the Department of Histopathology, Apollo Hospitals, Hyderabad. Of a total of 11,691 kidney biopsies over a 7-year period, from 2006 to 2012, 824 cases were diagnosed as FSGS, of which 610 cases in which detailed clinical findings were available were included in this study. FSGS was then categorized according to the Columbia classification. Results  FSGS, NOS was the predominant histomorphological variant. Serum creatinine was significantly high in the collapsing variant, followed by NOS. Follow-up data was available for 103 cases,72.8% had complete remission, 10.6% had partial remission, and in 16.5 % there was no remission. Relapses were observed in 6.7% cases, two patients (1.9%) succumbed, and 4.8% cases progressed to chronic kidney disease. Conclusion  This study showed that perihilar variant was less prevalent, with tip and cellular variants being more prevalent in Indian subcontinent compared to Western literature. Collapsing variant was also less common.

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局灶性和节段性肾小球硬化的哥伦比亚分类及其与临床预后的相关性研究。
局灶性和节段性肾小球硬化(FSGS)是成人和儿童肾病综合征的主要原因。“哥伦比亚FSGS分类”包括五个变体;未指定的(NOS)、尖端、门周、细胞和塌陷变异可能具有不同的预后和治疗意义。材料和方法这是一项回顾性研究,在海得拉巴阿波罗医院的组织病理学部门进行。在2006年至2012年7年间共11691例肾脏活检中,824例被诊断为FSGS,其中610例有详细临床表现的病例被纳入本研究。然后根据哥伦比亚分类对FSGS进行分类。结果FSGS、NOS是主要的组织形态学变异。塌缩型患者血清肌酐显著增高,其次为NOS。103例患者的随访数据显示,72.8%患者完全缓解,10.6%患者部分缓解,16.5%患者无缓解。复发6.7%,死亡2例(1.9%),进展为慢性肾脏疾病4.8%。结论本研究表明,与西方文献相比,印度次大陆的门缘变异较少,尖端变异和细胞变异更为普遍。崩溃变体也不太常见。
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来源期刊
Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
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发文量
99
审稿时长
31 weeks
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