Correlation Between Pathological Subtypes Of Focal Segmental Glomerulosclerosis And Clinical Prognosis In Southern Anhui

Objective: The influence of pathological subtypes on the prognosis of patients with FSGS and the study of the independent risk factors affecting the prognosis of patients.Methods: 126 cases of primary focal segmental glomerulosclerosis diagnosed by renal biopsy in Department of Nephrology,affiliated Yijishan Hospital of Wannan Medical College from July,2011 to October,2018.Analysis of the influence of pathological subtypes on the prognosis of FSGS patients by renal biopsy and clinical examination.Finally,binary logistic regression analysis was used to explore the independent risk factors influencing the prognosis of FSGS patients.Results: Among 126 patients with fsgs in southern Anhui province,non-special variant was the most,accounting for 44.4%,the proportion of patients with Perihilar variant is25.4%,the proportion of patients with Tip variant is 19.8%,the proportion of patients with Cellular variant is 7.2%,the proportion of patients with Collapsing variant is 3.2%.Of the patients with FSGS,72 were male and 54 were female,ratio of men to women listed as 1.33: 1.Non-special variant,Perihilar variant and Collapsing variant are mainly male patients,and the percentages are 66.1%,56.3% and 75%.The Tip variant and Cellular variant are mainly female patients,the percentages were 60 per cent and 55.6per cent.Among the patients with FSGS,66 patients had hypertension.Among them,non-special variant hypertension patients were the most,accounting for 62.5% of the total.There was no significant difference in the overall distribution of the incidence of various pathological subtypes of hypertension(P>0.05).Among all the pathological subtypes of FSGS,the highest level of 24-hour urinary protein was found in the Tip variant,while the lowest was in the Cellular variant.There was significant difference in the total distribution of 24 hours urinary protein in different pathological subtypes of FSGS(P<0.01).The results of inter-group comparison showed that there were significant differences between non-special variant and Perihilar variant,Cellular variant,Collapsing variant(P<0.05).There was significant difference between Perihilar variant,Cellular variant and Collapsing variant(P<0.05).There was significant difference between the Tip variant and the Cellular variant(P<0.05).There was significant difference between Cellular variant and Collapsing variant(P<0.05).There was no significant difference in the total distribution of serum albumin among the patients with different pathological subtypes of FSGS(P >0.05).There were 71 patients with hematuria in all pathological subtypes of fsgs,with the largest number of non-special type patient,there was no significant difference in the total distribution among the pathological subtypes(P>0.05).The results of comparison among groups showed that there was significant difference between non-special variant and Cellular variant,Collapsing variant(P<0.05),but there was no significant difference among other groups(P>0.05).Of all the pathological subtypes of FSGS,the GRF of Collapsing variant was the lowest,and the GRF of non-special variant was the highes.There was significant difference in total distribution(P<0.05).The results of comparison among groups showed that there was a statistical difference between non special variant and collapse variant(P<0.05),and there was no statistical difference in the other groups(P>0.05).The results of remission in patients with FSGS showed that the highest remission rate of non-special variant patients was 62.5%,followed by Perihilar variant and Tip variant,percentages were 56.2% and 52%.The curative effect of Cellular variant and collapse variant is poor,the remission rate is 44.4% and 25%.There was no significant difference in the overall distribution of the remission among the pathological subtypes(P>0.05),and there was no significant difference among the groups(P>0.05).The results of binary logistic regression analysis show that hypertension is an independent risk factor for the prognosis of patients with FSGS,and the prognosis of patients with hypertension is worse than that of patients without hypertension(P<0.05,OR=2.515);hematuria was an independent risk factor for the prognosis of patients with FSGS,and the prognosis of patients with hematuria was worse than that of patients without hematuria(P < 0.01 OR =4.134).With patients over 60 years of age as the reference group,patients under 40 years of age had a worse prognosis for each increase in age of 20 years(12-20: P<0.05,OR=10.817;21-40: P< 0.05,OR=8.853;40-60: P< 0.05,OR=6.923).FSGS pathological subtype,sex,urine protein,serum creatinine level at biopsy and serum albumin are not independent risk factors for prognosis of patients(P<0.05).Conclusion:1.In southern Anhui,the majority of FSGS patients were male,the most of pathological subtypes were non-special variant and the least of collapsing variant.The patients with non-special type and collapse type were younger,and the patients with portal type,apical type and cellular type were older.2.he pathological subtypes of fsgs have no effect on the prognosis of the patients.3.Age,hypertension and hematuria were independent risk factors for prognosis of patients with FSGS.Pathological subtypes,sex,urine protein,serum creatinine level at biopsy,serum albumin were not independent risk factors for prognosis of patients with FSGS.