Abstract:

Objective: To analyzed the incidences and risk factors of these complications in patients with focal segmental glomerulosclerosis. Methodology: Seventy patients with FSGS were involved in this study. Acute kidney Injury (AKI) was defined as a rise in serum creatinine to ≥50% above baseline or by ≥0.3mg/dL. Infection was diagnosed by a combination of clinical manifestations, laboratory tests and imaging examination. Thromboembolism was diagnosed by imaging methods. The risk factors for the complications were evaluated by logistic regression analysis.  Results: The incidences of AKI, infection and thromboembolism were 48.6%, 20.0%, 15.7%, respectively. The patients with AKI were more likely to be male with lower serum albumin, greater protein excretion, urine NAG and RBP, as well as more severe acute tubulo-interstitial damage in the pathological changes. At follow up, patients with an episode of AKI experienced a lower response rate. The patients with infection had a higher level of proteinuria and lower levels of serum albumin, globulin and IgG than those without infections. Prolonged hospital stay was increased the risk of infection, especially hospital acquired infecton. The levels of circulating endothelial cells (CECs) and von Willebrand factor (vWF) were higher in patients with thromboembolism than those without. Logistic regression analysis showed that increased RBP, a lower level of serum albumin, prolonged hospital stay, the increase of CECs and hemoglobin were independent risk factors for AKI, infection and thromboembolism, respectively.  Conclusion: The incidences of AKI, infection and thromboembolism in patients with FSGS were 48.6%, 20.0%, and 15.7%, respectively. Acute tubulointerstitial lesions, hypoalbuminemia, prolonged hospital stay and endothelial cell injury as well as pachyemia played important roles in the development of these complications.