{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T20:34:49Z","timestamp":1754598889864,"version":"3.30.2"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Travere Therapeutics Inc."}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Focal segmental glomerulosclerosis (FSGS) is a rare glomerular disease that can lead to reduced kidney function and kidney failure (KF). The objective of this study was to describe the epidemiology, characteristics, clinical outcomes, healthcare resource utilization, and costs associated with focal segmental glomerulosclerosis (FSGS) in United States (US) veterans.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective cohort study included patients in the National Veterans Affairs Health Care Network with \u22652 FSGS-associated diagnostic codes that were 30\u2013180 days apart (October 1999\u2013February 2021). Annual FSGS incidence and prevalence per 1,000,000 US veterans were calculated. Patient and disease characteristics as of the index date (date of first FSGS diagnosis) and baseline (6-months pre-index) comorbidities were described. Kaplan-Meier analyses were used to assess overall survival and time from index to KF or death, dialysis, and kidney transplant. Post-index medication use, HRU, and direct healthcare costs were summarized.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years. The mean age was 57.5 years, most patients were male (94.6%), and the most common comorbidity was hypertension (87.0%). The mean annual incidence and prevalence of FSGS during 2000\u20132020 were 19.6 and 164.7 per million veterans, respectively. Approximately half (51.5%) died during follow-up (median time: 11.6 years) and 76.9% had kidney failure (4.1 years). Overall, 43.3% underwent dialysis and 5.8% had a kidney transplant. During follow-up, statins and calcium channel blockers were commonly used (81.9% and 75.1%). During the first year post-index, 40% had an inpatient admission and 33% visited the emergency room; mean total healthcare cost per patient in the analysis was $36,543.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Among US veterans, FSGS is associated with considerable clinical and economic burdens. Better treatments for FSGS are needed to slow kidney disease progression, improve patient outcomes, and reduce the burden.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315302","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T18:25:16Z","timestamp":1734114316000},"page":"e0315302","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Epidemiology and burden of focal segmental glomerulosclerosis among United States Veterans: An analysis of Veteran\u2019s Affairs data"],"prefix":"10.1371","volume":"19","author":[{"given":"Deborah","family":"Goldschmidt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-7898","authenticated-orcid":true,"given":"Mark E.","family":"Bensink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng-Yi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherry","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-4287","authenticated-orcid":true,"given":"Yilu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizheng","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"issue":"25","key":"pone.0315302.ref001","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1056\/NEJMra1106556","article-title":"Focal segmental glomerulosclerosis","volume":"365","author":"VD D\u2019Agati","year":"2011","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0315302.ref002","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1159\/000508099","article-title":"Focal segmental glomerulosclerosis: State-of-the-art and clinical perspective","volume":"144","author":"A Shabaka","year":"2020","journal-title":"Nephron"},{"issue":"11","key":"pone.0315302.ref003","doi-asserted-by":"crossref","DOI":"10.1681\/ASN.2012040389","article-title":"Treatment of primary FSGS in adults","volume":"23","author":"SM Korbet","year":"2012","journal-title":"J Amer Soc Nephrol"},{"issue":"6","key":"pone.0315302.ref004","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1038\/ki.2010.485","article-title":"Clinical trials treating focal segmental glomerulosclerosis should measure patient quality of life","volume":"79","author":"DS Gipson","year":"2011","journal-title":"Kidney Int"},{"issue":"4","key":"pone.0315302.ref005","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1093\/ckj\/sfz092","article-title":"The longitudinal relationship between patient-reported outcomes and clinical characteristics among patients with focal segmental glomerulosclerosis in the Nephrotic Syndrome Study Network","volume":"13","author":"JP Troost","year":"2020","journal-title":"Clin Kidney J"},{"issue":"5","key":"pone.0315302.ref006","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.kint.2018.12.018","article-title":"Health-related quality of life in glomerular disease","volume":"95","author":"PA Canetta","year":"2019","journal-title":"Kidney Int"},{"issue":"10","key":"pone.0315302.ref007","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1016\/j.ekir.2021.07.030","article-title":"A retrospective study of clinical and economic burden of focal segmental glomerulosclerosis (FSGS) in the United States","volume":"6","author":"K Kalantar-Zadeh","year":"2021","journal-title":"Kidney Int Rep"},{"key":"pone.0315302.ref008","unstructured":"Nazareth TA, Kariburyo F, Kirkemo A, Xie L, Pavlova-Wolf A, Bartels-Peculis L, et al. 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