Primary focal segmental glomerulosclerosis in adults: presentation, prevalence and treatment outcomes in patients at Charlotte Maxeke Johannesburg Academic Hospital

Abstract

The presenting features and treatment of patients with Primary Focal Segmental Glomerulosclerosis (FSGS) were characterised in this study. Methods Adults with primary FSGS at Charlotte Maxeke Johannesburg Hospital from 2001-2010 were reviewed. 38 patients were identified; 8 were lost to follow-up after presentation and 30 were further characterised in terms of outcomes. Analysis was performed of the clinical presentation, therapeutic and cumulative outcomes. A p<0.05 was significant. Results The prevalence of primary FSGS was 7.2%, Blacks constituted 86.8% of cases and 65.7% were male. Most patients presented with the nephrotic syndrome and the most common histological subtype was the Classical variant. Black patients diagnosed with the disorder were younger (p=0.002); and had a predominance of the collapsing variant (p=0.95). Remission with first-line therapy was achieved in 73% of patients. A lower Glomerular filtration rate (eGFR) at presentation and poor cumulative end-point was noted (p=0.94). Conclusion Primary FSGS is a not-uncommon glomerular disorder in the South African Black population. Black patients present at a younger age and a high proportion have the collapsing subtype