Abstract |
Idiopathic focal segmental glomerulosclerosis (FSGS) is an infrequent renal biopsy diagnosis in the elderly. In our single-centre referral registry there were only 17 cases seen in 822 biopsies performed in patients aged 60 or over giving an incidence of 2%. These seventeen patients ranged from age 61 to 78 at the time of biopsy and were followed a median period of 29.5 months. The incidence of nephrotic syndrome at baseline was similar to younger adults (70.5%), but both hypertension (71%) and renal insufficiency (53%) were higher. Fifty-three percent (9/17) of the patients were treated with either steroids or a combination of steroids and cytotoxic therapy. A complete remission in proteinuria was observed in 44% of the treated patients versus none in the untreated patients. No relapses were seen in those that had a complete remission. As well, none of the patients with a complete remission, versus 9/14 (63%) of the untreated or non-responsive patients progressed to renal failure during the observation period. One patient who was treated with cytotoxic therapy and steroids subsequently died of a pancreatic carcinoma. Idiopathic FSGS is an infrequent glomerulopathy in the elderly but it is important given its malignant natural history. Alternate day prednisone for up to 6 months may be a reasonable approach since a complete remission in proteinuria was seen in 44% of our treated patients and this response was closely linked to a good long-term prognosis. The risks of therapy however must be carefully weighed against the potential benefit in each case because of the advanced age of these patients.
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Authors | R Nagai, D C Cattran, Y Pei |
Journal | Clinical nephrology
(Clin Nephrol)
Vol. 42
Issue 1
Pg. 18-21
(Jul 1994)
ISSN: 0301-0430 [Print] Germany |
PMID | 7923961
(Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)
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Chemical References |
- Cyclophosphamide
- Prednisone
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Topics |
- Aged
- Cyclophosphamide
(therapeutic use)
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Glomerulosclerosis, Focal Segmental
(drug therapy, epidemiology)
- Humans
- Incidence
- Male
- Prednisone
(therapeutic use)
- Prognosis
- Registries
- Retrospective Studies
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