A retrospective study of focal segmental glomerulosclerosis: clinical criteria can identify patients at high risk for recurrent disease after first renal transplantation

BMC Nephrology

Jack FM Wetzels¹  Elisabeth AM Cornelissen²  Jan AJG van den Brand¹  Jeroen KJ Deegens¹  Rutger JH Maas¹ 

[1] Department of Nephrology 464, Radboud University Nijmegen Medical Center, PO Box 9101, Nijmegen, HB 6500, The Netherlands;Department of Pediatric Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

关键词: Risk factors;    Renal transplantation;    Recurrence;    FSGS;   

Others  :  1082991
DOI  :  10.1186/1471-2369-14-47

 received in 2012-06-20, accepted in 2013-02-14,  发布年份 2013

【 摘 要 】

Background

Focal segmental glomerulosclerosis (FSGS) is a frequent cause of end-stage renal disease. Renal transplantation in patients with FSGS is often complicated by disease recurrence, which is associated with poor outcome. There are no tests that reliably predict recurrence of FSGS after transplantation. The aim of this study was to evaluate if clinical criteria can identify patients at high risk for recurrent disease.

Methods

We retrospectively studied 94 patients who received a first renal transplant at a median age of 37 years (range 5–69 years). Patients were assigned to one of three groups: familial or genetic FSGS (group I; n=18), secondary FSGS (group II; n=10) and idiopathic FSGS (group III; n=66). Pretransplant clinical characteristics were analyzed to determine predictors of a recurrence after transplantation.

Results

FSGS only recurred in patients with idiopathic FSGS (group III; 42%). Patients with a recurrence had a significantly lower serum albumin, higher 24-hour proteinuria and higher estimated glomerular filtration rate at diagnosis. Serum albumin at diagnosis was the only independent predictor of a recurrence in patients with idiopathic FSGS. Patients with recurrent FSGS had more acute rejection episodes (54% vs. 27%, P =0.02) and lower five year graft survival compared to patients without a recurrence (50 vs. 82%, P <0.01).

Conclusions

Clinical criteria allow identification of patients at high risk of recurrent FSGS after renal transplantation. This information can be used in the counseling and management of patients with FSGS.

【 授权许可】

   
2013 Maas et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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