{
    "abstract": "Primary Focal and Segmental glomerulosclerosis (FSGS) is one of the most common causes of idiopathic nephrotic syndrome. Our aim was to describe a large cohort of patients with primary FSGS, identify risk factors associated with worse renal survival and assess the impact of different immunosuppressive regiments on renal survival.\nThis was a historical cohort study of adults who were diagnosed with primary FSGS from March 26, 1982, to September 16, 2020. The primary outcome was progression to ESRD.\nWe included 579 patients. The mean age was 46 (\u00b115) years of age, with 378 (65%) males and median 24-hour proteinuria was 3.8 (2-6) g. In multivariable analysis only eGFR (HR: 0.97 per ml/min increase, 95% CIs 0.95-0.98) and remission status (complete remission (HR: 0.03, 95% CIs 0.003-0.22) and partial remission (HR: 0.28, 95% CIs 0.13-0.61) compared to no remission) were associated with renal survival. Among patients who received immunosuppression compared to those that did not, there was a higher percentage of complete remission (121 (41%) vs. 40 (24%), p<0.001), and higher percentage of relapses (135 (64%) vs. 27 (33%), p<0.001). Immunosuppression and its type (glucocorticoids vs. cyclosporine \u00b1 glucocorticoids) were not associated with renal survival.\nIn primary FSGS, complete and partial remission were associated with improved renal survival. Further randomized studies are needed to assess the efficacy of different therapeutic agents and guide treatment.",
    "authors": [
        {
            "affiliation": "Department of Nephrology, Laiko General Hospital, National and Kapodistrian University, Athens, Greece.",
            "firstname": "Smaragdi",
            "initials": "S",
            "lastname": "Marinaki"
        },
        {
            "affiliation": "Department of Nephrology, Laiko General Hospital, National and Kapodistrian University, Athens, Greece.",
            "firstname": "Panagiotis",
            "initials": "P",
            "lastname": "Kompotiatis"
        },
        {
            "affiliation": "Department of Nephrology, Laiko General Hospital, National and Kapodistrian University, Athens, Greece.",
            "firstname": "Ioannis",
            "initials": "I",
            "lastname": "Michelakis"
        },
        {
            "affiliation": "Department of Nephrology, Hippokration General Hospital, Aristotle University, Thessaloniki, Greece.",
            "firstname": "Maria",
            "initials": "M",
            "lastname": "Stangou"
        },
        {
            "affiliation": "Department of Nephrology, Hippokration General Hospital, Aristotle University, Thessaloniki, Greece.",
            "firstname": "Aikaterini",
            "initials": "A",
            "lastname": "Papagianni"
        },
        {
            "affiliation": "Department of Nephrology, General Hospital of Nikaia, Piraeus, Greece.",
            "firstname": "Maria",
            "initials": "M",
            "lastname": "Koukoulaki"
        },
        {
            "affiliation": "Department of Nephrology, General Hospital of Nikaia, Piraeus, Greece.",
            "firstname": "Synodi",
            "initials": "S",
            "lastname": "Zerbala"
        },
        {
            "affiliation": "Department of Nephrology, Venizelio General Hospital of Heraklion, Heraklion Crete, Greece.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Xydakis"
        },
        {
            "affiliation": "Department of Nephrology, Hellenic Red Cross Hospital Korgialeneio-Benakeio, Greece.",
            "firstname": "Nikolaos",
            "initials": "N",
            "lastname": "Kaperonis"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.",
            "firstname": "Evangelia",
            "initials": "E",
            "lastname": "Dounousi"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Larissa, Larissa, Greece.",
            "firstname": "Spyridon",
            "initials": "S",
            "lastname": "Golfinopoulos"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Larissa, Larissa, Greece.",
            "firstname": "Ioannis",
            "initials": "I",
            "lastname": "Stefanidis"
        },
        {
            "affiliation": "Department of Nephrology, Evangelismos General Hospital, Athens, Greece.",
            "firstname": "Aggeliki",
            "initials": "A",
            "lastname": "Paikopoulou"
        },
        {
            "affiliation": "Department of Nephrology, Gennimatas General Hospital of Athens, Athens, Greece.",
            "firstname": "George",
            "initials": "G",
            "lastname": "Moustakas"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Heraklion, Heraklion Crete, Greece.",
            "firstname": "Kostas",
            "initials": "K",
            "lastname": "Stylianou"
        },
        {
            "affiliation": "Department of Nephrology, General Hospital of Chania, Chania Crete, Greece.",
            "firstname": "Ioannis",
            "initials": "I",
            "lastname": "Tzanakis"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Patras, Patras, Greece.",
            "firstname": "Marios",
            "initials": "M",
            "lastname": "Papasotiriou"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Patras, Patras, Greece.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Goumenos"
        },
        {
            "affiliation": "Department of Nephrology, Hatzikosta General Hospital of Ioannina, Ioannina, Greece.",
            "firstname": "Aimilios",
            "initials": "A",
            "lastname": "Andrikos"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Alexandroupolis, Alexandroupoli, Greece.",
            "firstname": "Pelagia",
            "initials": "P",
            "lastname": "Kriki"
        },
        {
            "affiliation": "Department of Nephrology, University Hospital of Alexandroupolis, Alexandroupoli, Greece.",
            "firstname": "Stylianos",
            "initials": "S",
            "lastname": "Panagoutsos"
        },
        {
            "affiliation": "Department of Nephrology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece.",
            "firstname": "Eva",
            "initials": "E",
            "lastname": "Kiousi"
        },
        {
            "affiliation": "Department of Nephrology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece.",
            "firstname": "Eirini",
            "initials": "E",
            "lastname": "Grapsa"
        },
        {
            "affiliation": "Department of Nephrology, General Hospital of Volos, Volos, Greece.",
            "firstname": "Georgios",
            "initials": "G",
            "lastname": "Koutroumpas"
        },
        {
            "affiliation": "Department of Nephrology, Papageorgiou General Hospital of Thessaloniki, Thessaloniki, Greece.",
            "firstname": "Panagiotis",
            "initials": "P",
            "lastname": "Pateinakis"
        },
        {
            "affiliation": "Department of Nephrology, Papageorgiou General Hospital of Thessaloniki, Thessaloniki, Greece.",
            "firstname": "Dorothea",
            "initials": "D",
            "lastname": "Papadopoulou"
        },
        {
            "affiliation": "Section of Nephrology, 1st Department of Medicine, AHEPA University General Hospital, Thessaloniki, Greece.",
            "firstname": "Vasilios",
            "initials": "V",
            "lastname": "Liakopoulos"
        },
        {
            "affiliation": "Department of Nephrology, Attikon University Hospital, National and Kapodistrian University, Athens, Greece.",
            "firstname": "Dimitra",
            "initials": "D",
            "lastname": "Bacharaki"
        },
        {
            "affiliation": "Department of Nephrology, Hippokration General Hospital, Athens, Greece.",
            "firstname": "Penelope",
            "initials": "P",
            "lastname": "Kouki"
        },
        {
            "affiliation": "Department of Nephrology, Hippokration General Hospital, Athens, Greece.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Petras"
        },
        {
            "affiliation": "Department of Nephrology, Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece.",
            "firstname": "Gerasimos",
            "initials": "G",
            "lastname": "Bamichas"
        },
        {
            "affiliation": "Department of Nephrology, Laiko General Hospital, National and Kapodistrian University, Athens, Greece.",
            "firstname": "Ioannis",
            "initials": "I",
            "lastname": "Boletis"
        }
    ],
    "conclusions": "In primary FSGS, complete and partial remission were associated with improved renal survival. Further randomized studies are needed to assess the efficacy of different therapeutic agents and guide treatment.",
    "copyrights": "Copyright: \u00a9 2024 Marinaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
    "doi": "10.1371/journal.pone.0315124\n10.1016/s0272-6386(97)90485-6\n10.1681/ASN.2017090958\n10.1016/s0272-6386(00)70258-7\n10.1016/j.mayocp.2017.09.011\n10.1152/ajprenal.00349.2015\n10.2215/CJN.05960616\n10.3389/fimmu.2023.1247606\n10.1056/NEJM199604043341402\n10.1038/nm.2443\n10.1093/ndt/gfu035\n10.1038/nm.3142\n10.1186/s12882-024-03695-8\n10.1053/ajkd.1998.v32.pm9669427\n10.1093/qjmed/hci072\n10.1681/ASN.2004070593\n10.1016/0272-6386(95)90120-5\n10.1046/j.1523-1755.1999.00778.x\n10.1681/ASN.V7156\n10.1159/000093993\n10.2215/CJN.07110615\n10.1016/j.mayocp.2021.01.037\n10.1093/ckj/sfx143\n10.7326/0003-4819-150-9-200905050-00006\n10.1016/s0272-6386(12)80128-4\n10.1053/j.ajkd.2020.04.014\n10.1177/2054358117692559\n10.2215/CJN.06100612\n10.1093/ckj/sfu100\n10.1093/ckj/sfae131",
    "journal": "PloS one",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-12-18",
    "pubmed_id": "39693288\n9370176\n29321142\n10793022\n29110886\n26719363\n28242845\n37795085\n8596570\n21818086\n24589721\n23502960\n39134955\n9669427\n15879445\n15716334\n7702047\n34556256\n10594798\n8808110\n16785738\n26912551\n34120753\n29644057\n19414839\n8203357\n34499164\n32791086\n28321320\n23220425\n25503953\n38989280",
    "results": "We included 579 patients. The mean age was 46 (\u00b115) years of age, with 378 (65%) males and median 24-hour proteinuria was 3.8 (2-6) g. In multivariable analysis only eGFR (HR: 0.97 per ml/min increase, 95% CIs 0.95-0.98) and remission status (complete remission (HR: 0.03, 95% CIs 0.003-0.22) and partial remission (HR: 0.28, 95% CIs 0.13-0.61) compared to no remission) were associated with renal survival. Among patients who received immunosuppression compared to those that did not, there was a higher percentage of complete remission (121 (41%) vs. 40 (24%), p<0.001), and higher percentage of relapses (135 (64%) vs. 27 (33%), p<0.001). Immunosuppression and its type (glucocorticoids vs. cyclosporine \u00b1 glucocorticoids) were not associated with renal survival.",
    "title": "Renal survival and treatment of adult patients with Primary Focal Segmental glomerulosclerosis: A historical cohort study of the National Greek Registry.",
    "xml": "<Element 'PubmedArticle' at 0x788506ceac00>"
}