The Humanistic Burden of Focal Segmental Glomerulosclerosis on Patients and Care‑Partners in the United States
Quality of Life Research – 2025
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
Contributors:
Goldschmidt D, Bensink ME, Zhou ZY et al.
Goldschmidt D, Bensink ME, Zhou ZY et al.
DOI:
10.1371/journal.pone.0315302
10.1371/journal.pone.0315302
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
Related Content
The Humanistic Burden of Focal Segmental Glomerulosclerosis on Patients and Care‑Partners in the United States
Quality of Life Research – 2025
Kidney Failure Attributed to Focal Segmental Glomerulosclerosis: A USRDS Retrospective Cohort Study of Epidemiology, Treatment Modalities, and Economic Burden
Kidney Medicine – 2023
Footnotes
FSGS, focal segmental glomerulosclerosis; KF, kidney failure; US, United States; VA, Veterans Affairs.
- Goldschmidt D et al. PLOS ONE. 2024;19(12):e0315302.
- Korbet SM. J Am Soc Nephrol. 2012;23(11):1769-1776.
- Shabaka A et al. Nephron. 2020;144(9):413-427.
- D’Agati VD et al. N Engl J Med. 2011;365(25):2398-2411.
- Troost JP et al. Clin Kidney J. 2020;13(4):597-606.
- Canetta PA et al. Kidney Int. 2019;95(5):1209-1224.
- Kalantar-Zadeh K et al. Kidney Int Rep. 2021;6(10):2679-2688.
- Himmelfarb J et al. Nat Rev Nephrol. 2020;16(10):573-585.
- Goh ZS and Griva K. Int J Nephrol Renovasc Dis. 2018;11:93-102.
- Abdel-Kader K et al. BMC Nephrol. 2014;15(1):29.
- Kim JC et al. J Cachexia Sarcopenia Muscle. 2014;5(3):209-220.
- Ismael NH and Rashid AO. Galen Med J. 2020;9:e1987.
MA-DS-25-0056 | July 2025