SP063CLINICAL AND PATHOLOGICAL FEATURES OF FOCAL SEGMENTAL GLOMERULOSCLEROSIS PATHOLOGIC VARIANTS IN CHINESE ADULTS

Abstract

Introduction and Aims: Exploring the clinical and pathological features of each variant of focal segmental glomerulosclerosis (FSGS) under the Columbia classifi-cation in Chinese adults. Method(s): This retrospective study included 359 patients who underwent renal biopsy in our center and were diagnosed as primary FSGS from January 2002 till September 2017. All the patients were classified into not-otherwise specified(NOS), perihilar, tip, collapsing or cellular by the Columbia classification. We analyzed the proportion of each variant and the difference in age, gender, 24H proteinuria, the occur-rence rate of hypertension, hematuria and nephrotic syndrome, renal involvement manifestation, ALb, Scr, eGFR, CKD staging, the proportion of glomerulosclerosis, injury of renal interstitium and renal vascular between the 5 variants. Result(s): NOS variant was the oldest and tip variant was the youngest among the 5 variants. (41 vs 32) In collapsing and tip variants, the proportion of male patients reached more than 70%. Perihilar variants showed lower incidence of hypertension and hematuresis than other 4 variants, tip variant showed higher occurrence rate of NS than other 4 variants, meanwhile, tip variant showed highest 24H proteinuria and lowest Alb among the 5 variants. (p<0.05) Most of perihilar variant presented with simple protei-nuria,while other variants showed a balanced trend of proteinuria and hematuria com-plicated with proteinuria.(p<0.05) Collapsing variant showed the highest Scr and the lowest eGFR, while tip and perihilar variants showed the lower Scr and the higher eGFR, the remaining variants between these three variants. 80.4% perihilar variant and 78.8% tip variant were in CKD1-2, all the collapsing variants were in CKD4-5. In lipid metabolism, TC and LDL of tip variant were significantly higher than other variants. (p<0.05)The proportion of glomerulosclerosis(segmental/global) were respectively 12.5%/18.5%(NOS), 6.7%/4.3%(perihilar), 3.2%/0.1%(tip), 31.4%/31.6%(collaps-ing), 10.2%/26.2%(cellular), collapsing variant showed the highest proportion of seg-mental sclerosis and global sclerosis(31.4%,31.6%), tip variants showed the lowesst proportion of segmental sclerosis and global sclerosis(3.2%,0.1%), According to the TIL index, 97% tip variant score 0-1, followed by perihilar(80%) and NOS(60%), all the collapsing and cellular variants score 2-3. (p<0.05) Conclusion(s): Like the other population, our results also showed great differences in pathology and clinical features between variants of Columbia classification. Our data showed the highest prevalence of NOS variant(73.5%), follwed by perihilar(14.2%), tip(9.2%), collapsing variants(2.5%) and the lowest prevalence of cellular var-iants(0.6%).