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Epidemiology and Burden of Focal Segmental Glomerulosclerosis Among United States Veterans: An Analysis of Veteran’s Affairs Data

Journal article
Published on December 13, 2024

Topics: Nephrology FSGS Non-product Observational Summary

Contributors:
Goldschmidt D, Bensink ME, Zhou ZY et al.
Name of Journal:
PLOS ONE


View Publication
DOI:
10.1371/journal.pone.0315302
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Home » Publications » FSGS Burden in US Veterans

Summary

New insights into focal segmental glomerulosclerosis (FSGS) epidemiology from United States (US) veterans’ healthcare data1


Background

Focal segmental glomerulosclerosis (FSGS) is a rare but serious group of heterogeneous conditions marked by podocyte injury and is a leading cause of kidney failure (KF).1-3

FSGS is associated with significant clinical and economic burden, including progression to KF, reduced quality of life, and high healthcare resource utilization and costs.1,2,4-12

As new treatment options may emerge in the United States (US), there is a need to better understand FSGS, particularly in high-risk populations such as US veterans.1


Aim

This study aimed to describe the epidemiology, patient characteristics, treatment patterns, and clinical and economic burdens of FSGS in US veterans.1


Approach

A large retrospective cohort study was conducted using Veterans Affairs (VA) healthcare data from October 1999 to February 2021.1

Patients with ≥2 FSGS-related diagnosis codes recorded 30-180 days apart were included.1

Annual incidence and prevalence rates of FSGS were calculated from 2000 to 2020.1


Findings

The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years.1

The mean annual incidence of FSGS was 19.6 per million veterans, and the mean annual prevalence was 164.7 per million veterans.1

FSGS was associated with considerable clinical burden1:

  • 76.9% of patients experienced KF or death
    • Median time to first event: 4.1 years
  • 43.3% initiated dialysis
  • 5.8% underwent kidney transplant

Frequently prescribed medications included1:

  • Statins: 81.9%
  • Calcium channel blockers: 75.1%
  • Glucocorticoids: 70.1%

Within the first year1:

  • 40% of patients were hospitalized
  • 33% had at least one emergency room visit

The healthcare costs of FSGS were high; the mean annual healthcare cost was $36,543 per patient.1


Key takeaway

This analysis of the epidemiology of FSGS in the VA population highlights the considerable clinical and economic burdens of FSGS in US veterans, including progression to KF and high healthcare costs.1

These findings support the need for improved FSGS treatment options that delay or prevent KF and reduce the burden of FSGS on patients and healthcare systems.1


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The Humanistic Burden of Focal Segmental Glomerulosclerosis on Patients and Care‑Partners in the United States

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Kidney Failure Attributed to Focal Segmental Glomerulosclerosis: A USRDS Retrospective Cohort Study of Epidemiology, Treatment Modalities, and Economic Burden

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Footnotes

FSGS, focal segmental glomerulosclerosis; KF, kidney failure; US, United States; VA, Veterans Affairs.

  1. Goldschmidt D et al. PLOS ONE. 2024;19(12):e0315302.
  2. Korbet SM. J Am Soc Nephrol. 2012;23(11):1769-1776.
  3. Shabaka A et al. Nephron. 2020;144(9):413-427.
  4. D’Agati VD et al. N Engl J Med. 2011;365(25):2398-2411.
  5. Troost JP et al. Clin Kidney J. 2020;13(4):597-606.
  6. Canetta PA et al. Kidney Int. 2019;95(5):1209-1224.
  7. Kalantar-Zadeh K et al. Kidney Int Rep. 2021;6(10):2679-2688.
  8. Himmelfarb J et al. Nat Rev Nephrol. 2020;16(10):573-585.
  9. Goh ZS and Griva K. Int J Nephrol Renovasc Dis. 2018;11:93-102.
  10. Abdel-Kader K et al. BMC Nephrol. 2014;15(1):29.
  11. Kim JC et al. J Cachexia Sarcopenia Muscle. 2014;5(3):209-220.
  12. Ismael NH and Rashid AO. Galen Med J. 2020;9:e1987.

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