Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2021, Vol. 30 ›› Issue (2): 107-112.DOI: 10.3969/j.issn.1006298X.2021.02.002
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Abstract: Objective:To explore the clinicopathological features and allograft outcomes of posttransplant focal segmental glomerulosclerosis (FSGS). Methodology:Patients with kidney allograft biopsyproven FSGS from January 2013 to December 2019 were studied retrospectively and divided into nephroticrange proteinuria (NP) group and nonnephroticrange proteinuria (nNP) group for comparative analysis. Results:Fiftytwo patients were enrolled (19 cases in NP group and 33 cases in nNP group).Fortyseven (904%) were male.The median time from transplantation to allograft biopsy was 124 months.The median serum creatinine and proteinuria were 2033 μmol/L and 25 g/24h.The not otherwise specified (NOS),collapsing,cellular,tip and perihilar variant type of FSGS accounted for 692%,115%,77%,77% and 38%,respectively.Podocyte hyperplasia was found in 29 (558%) patients,and pseudocrescents were present in 7 (135%) patients.Diffuse foot process effacement (FPE) was observed in 18 of 32 (563%) patients.The NP group was diagnosed earlier after transplantation and had higher incidence of edema and infection at biopsy,and more severe degree of tubulointerstitial lesions and FPE than the nNP group (all P<005).Clinical followup was available for 41 patients with a median time of 169 months,and 17 (415%) developed allograft failure.Kidney allograft survival rates were significantly lower in the NP group than in the nNP group (P=0040).Partial or complete remission rates were 600%,500% and 364% in plasma exchange and rituximab (PE+RTX) group,RTX group and nonPE/RTX group,respectively. Conclusion: Patients with posttransplant FSGS mainly presented with moderate proteinuria and allograft dysfunction;those with early onset after transplantation had more proteinuria,more severe foot process effacement and worse allograft survival.
ZHU Ying, XU Feng, LIANG Shaoshan, LIANG Dandan, ZHU Xiaodong, YANG Fan, CHEN Jinsong, ZENG Caihong. Clinicopathological features and allograft outcomes of posttransplant focal segmental glomerulosclerosis#br#
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URL: http://www.njcndt.com/EN/10.3969/j.issn.1006298X.2021.02.002
http://www.njcndt.com/EN/Y2021/V30/I2/107