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Abstract
The data regarding primary FSGS (pFSGS) from different parts of the world differ. While the prevalence of pFSGS has been increasing in Western countries like the USA, it follows an inconsistent trend in Europe and Asia and a decreasing trend in Far Eastern countries such as China in the last two decades. There are undetermined factors to explain those national and geographic discrepancies. Herein, we aimed to reveal the current prevalence with clinical and histopathological characteristics of pFSGS in Turkish adults. This study includes the biopsy-proven pFSGS patients data recorded between 2009 and 2019, obtained from the national multicenter primary glomerulonephritis registry system of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database. 850 of the 3875 primer glomerulonephritis patients(21.9%) have pFSGS. The mean age is 40.5 ± 14.2 and 435 (51.2%) of patients are male. Nephrotic syndrome is the most common biopsy indication (59.2%). 32.6% of patients have hematuria, 15.2% have leukocyturia and 7.8% have both. Serum creatinine, albumin, and proteinuria are 1.0 mg/dL (IQR = 0.7–1.4) mg/dl, 3.4 ± 0.9 g/dl, 3400 mg/day(IQR, 1774–5740), respectively. Females have lower mean arterial pressure (− 2.2 mmHg), higher eGFR (+ 10.0 mL/min/1.73 m2), and BMI (+ 1.6 kg/m2) than males. Thickened basal membrane(76.6%) and mesangial proliferation (53.5%) on light microscopy are the major findings after segmental sclerosis. IgM (32.7%) and C3 (32.9%) depositions are the most common findings on immunofluorescence microscopy. IgM positivity is related to lower eGFR, serum albumin, and higher proteinuria. The prevalence of pFSGS is stable although slightly increasing in Turkish adults. The characteristics of the patients are similar to those seen in Western countries.
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1 Trakya University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Edirne, Turkey (GRID:grid.411693.8) (ISNI:0000 0001 2342 6459)
2 Sutcu Imam University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Kahramanmaras, Turkey (GRID:grid.411741.6) (ISNI:0000 0004 0574 2441)
3 Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.9601.e) (ISNI:0000 0001 2166 6619)
4 Kocaeli University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Kocaeli, Turkey (GRID:grid.411105.0) (ISNI:0000 0001 0691 9040)
5 Ankara Numune Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Ankara, Turkey (GRID:grid.413791.9) (ISNI:0000 0004 0642 7670)
6 Health Science University, Istanbul Hamidiye Sisli Etfal Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.416011.3) (ISNI:0000 0004 0642 8884)
7 Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.506076.2) (ISNI:0000 0004 1797 5496)
8 Akdeniz University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Antalya, Turkey (GRID:grid.29906.34) (ISNI:0000 0001 0428 6825)
9 Kutahya Health Science University, Evliya Celebi Yuksek Ihtisas Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Kutahya, Turkey (GRID:grid.29906.34) (ISNI:0000 0004 7832 1680)
10 Medipol University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.411781.a) (ISNI:0000 0004 0471 9346)
11 Pamukkale University, Faculty of Medicine, Department of InternalMedicine, Division of Nephrology, Denizli, Turkey (GRID:grid.411742.5) (ISNI:0000 0001 1498 3798)
12 Sakarya University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Sakarya, Turkey (GRID:grid.49746.38) (ISNI:0000 0001 0682 3030)
13 Sultan Abdulhamid Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.414850.c) (ISNI:0000 0004 0642 8921)
14 Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Malatya, Turkey (GRID:grid.411650.7) (ISNI:0000 0001 0024 1937)
15 Eskisehir Osmangazi University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Eskişehir, Turkey (GRID:grid.164274.2) (ISNI:0000 0004 0596 2460)
16 Health Science University, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.414177.0) (ISNI:0000 0004 0419 1043)
17 Izmir Bozyaka Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Izmir, Turkey (GRID:grid.414879.7) (ISNI:0000 0004 0415 690X)
18 Dicle University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Diyarbakir, Turkey (GRID:grid.411690.b) (ISNI:0000 0001 1456 5625)
19 Afyon Kocatepe University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Afyon, Turkey (GRID:grid.411108.d) (ISNI:0000 0001 0740 4815)
20 Erciyes University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey (GRID:grid.411739.9) (ISNI:0000 0001 2331 2603)
21 Samsun 19 Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Samsun, Turkey (GRID:grid.411049.9) (ISNI:0000 0004 0574 2310)
22 Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Ankara, Turkey (GRID:grid.7256.6) (ISNI:0000 0001 0940 9118)
23 Bezmialem Vakif University School of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.411675.0) (ISNI:0000 0004 0490 4867)
24 Darıca Farabi Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Kocaeli, Turkey (GRID:grid.411675.0)
25 Selcuk University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Konya, Turkey (GRID:grid.17242.32) (ISNI:0000 0001 2308 7215)
26 Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Ankara, Turkey (GRID:grid.14442.37) (ISNI:0000 0001 2342 7339)
27 Kartal Lutfi Kirdar City Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.14442.37)
28 Okmeydanı Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey (GRID:grid.416316.7) (ISNI:0000 0004 0642 8817)
29 Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Internal Medicine, Division of Nephrology, Bursa, Turkey (GRID:grid.416316.7)
30 Gazi University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Ankara, Turkey (GRID:grid.25769.3f) (ISNI:0000 0001 2169 7132)