Treatment and Outcome of Idiopathic Focal Segmental Glomerulosclerosis: Immunosuppressive Agents or Renin Angiotensin System Inhibitors

OBJECTIVE: We compared the effi cacy and safety of 12 months of three different treatment regimens.

MATERIAL and METHODS: We retrospectively investigated the pathological and clinical features of 70 patients with FSGS confi rmed by biopsy. Patients with secondary FSGS, estimated glomerular fi ltration rate <30 mL/min/1.73 m2 and history of diabetes mellitus were excluded. Eligible 51 patients were randomly assigned to receive treatment with renin–angiotensin system (RAS) inhibitors (group 1, n=13), steroid (group 2, n=22) or steroid + Cyclosporine (CsA) (group 3, n=16).

RESULTS: At the end of the one year, remission ocurred in 7 patients (53.8%) (4 complete and 3 partial) in group 1, 15 patients (68%) (12 complete and 3 partial) in group 2 and 8 patients (50%) (6 complete and 2 partial) in group 3 (p=0.483). The baseline proteinuria levels of patients in group 2 (5.41±3.91 g/day) and group 3 (5.96±4.83 g/day) were signifi cantly decreased to 2.03±3.16 g/day (p=0.004) and 2.03±2.40 g/day (p=0.012), respectively. However, the baseline proteinuria levels of patients in group 1 were not signifi cantly decreased at one year of treatment.

CONCLUSION: Steroid treatment or CsA in combination with low-dose steroids show similar effi cacy in inducing remission in patients with idiopathic FSGS.