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Utility of Columbia classification in focal segmental glomerulosclerosis: Renal prognosis and treatment response among the pathological variants

Nephrology Dialysis Transplantation Aug 13, 2020

Tsuchimoto A, Matsukuma Y, Ueki K, et al. - Since the utility of the Columbia classification (Col-class) for focal segmental glomerulosclerosis (FSGS) has not yet been completely confirmed, researchers explored the difference of a composite renal endpoint, defined as doubling of serum creatinine and/or occurrence of end-stage renal disease, in pathological variants. For this purpose, they selected 201 FSGS patients from 10 nephrology centers in Japan. To prove the utility of the Col-class to predict renal results, sensitivity analysis was carried out. Cases were grouped into the following variants: not otherwise specified, perihilar, cellular, tip and collapsing. No tip variant patients reached the renal endpoint. Overall, in Japanese patients with FSGS, the usefulness of the Col-class for predicting renal prognosis was evident. In the tip variant and in the collapsing variant, the observed prognosis was good and poor, respectively, and the cellular variant treated with steroid/immunosuppression was suggested to have a good clinical course.

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