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Fsgs transplant

S H Jiang, A L Kennard, G D Walters
BACKGROUND: Recurrence of primary glomerulonephritis in the post-transplant period has been described in the literature but the risk remains poorly quantified and its impact on allograft outcomes and implications for subsequent transplants remain under-examined. Here we describe the rates and timing of post-transplant glomerulonephritis recurrence for IgA nephropathy, focal segmental glomerulosclerosis, mesangiocapillary GN and membranous GN based on 28 years of ANZDATA registry transplant data...
December 3, 2018: BMC Nephrology
Ru-Chun Yang, Xiao-Ling Zhu, Jun Wang, Feng Wan, Hua-Qin Zhang, Yi Lin, Xuan-Li Tang, Bin Zhu
BACKGROUND: Focal segmental glomerulosclerosis (FSGS) is the most common glomerular etiology of end-stage kidney disease (ESKD). Increasing evidence has indicated the reparative potential of mesenchymal stem cells (MSCs) in damaged diseased kidneys. However, the effect of bone marrow mesenchymal stem cells (BMSCs) on the FSGS progression remains unclear. This study aimed to investigate the protective effects of BMSCs on FSGS progression. METHODS: A rat model of FSGS was generated via unilateral nephrectomy plus adriamycin injection...
November 22, 2018: BMC Nephrology
Natàlia Puig-Gay, Conxita Jacobs-Cacha, Joana Sellarès, Lluís Guirado, Francisco González Roncero, Carlos Jiménez, Sofía Zárraga, Javier Paul, Ricardo Lauzurica, Ángel Alonso, Ana Fernández, Isabel Beneyto, Auxiliadora Mazuecos, Domingo Hernández, Alberto Rodriguez-Benot, Antonio Franco, Luisa Jimeno, Marta Crespo, Anna Meseguer, Francesc Moreso, Daniel Seron, Joan Lopez-Hellin, Carmen Cantarell
Recurrence of idiopathic focal segmental glomerulosclerosis (FSGS) is a serious complication after kidney transplantation. FSGS relapse is suspected by a sudden increase in proteinuria but there is not an accurate noninvasive diagnostic tool to confirm this entity or to detect patients at risk. We aimed to validate the diagnostic performance of ApoA-Ib to detect FSGS relapses by measuring urinary ApoA-Ib in a retrospective cohort of 61 kidney transplanted patients (37 FSGS and 24 non-FSGS). In addition, to assess the ApoA-Ib predictive ability, ApoA-Ib was measured periodically in a prospective cohort of 13 idiopathic FSGS patients who were followed during 1 year after transplantation...
November 8, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Olivier Gribouval, Olivia Boyer, Aurélie Hummel, Jacques Dantal, Frank Martinez, Rebecca Sberro-Soussan, Isabelle Etienne, Dominique Chauveau, Michel Delahousse, Arnaud Lionet, Julien Allard, Claire Pouteil Noble, Marie-Josèphe Tête, Laurence Heidet, Corinne Antignac, Aude Servais
Monogenic forms of Steroid-Resistant Nephrotic Syndrome (SRNS) have been widely characterized, but genetic screening paradigms preferentially address congenital, infantile onset, and familial cases. Our aim was to characterize the distribution of disease-causing gene mutations in adults with sporadic SRNS or focal segmental glomerulosclerosis (FSGS). We selected adult patients with non-syndromic, biopsy-proven FSGS or SRNS in the absence of known family history. Strict clinical criteria included lack of response to glucocorticoids and cyclosporine, and no recurrence after kidney transplantation...
November 2018: Kidney International
S Jung, K-M Park, J Hah, K C Hong, S-D Hwang, J Song
Focal segmental glomerulosclerosis (FSGS) is the most common form of post-transplant glomerulonephritis. We describe a case where a biopsy proved that early recurrence of FSGS on postoperative day 1 was the cause of delayed graft function. A 39-year-old man, on hemodialysis for 15 years due to polycystic kidney disease, received a cadaveric renal transplantation. On postoperative day 1, his hourly urine output decreased from 700-800 mL to 50 mL. The graft biopsy showed a mild acute kidney injury confusing nephrotic syndrome...
October 2018: Transplantation Proceedings
R Deng, Y Dai, H Zhang, L Liu, J Li, Y Xiong, S Deng, Q Fu, C Wang
Glomerulonephritis recurrence has emerged as one of the leading causes of allograft loss. We aimed to investigate the effect of living-related and deceased donation on the incidence of renal allograft glomerulonephritis and its effect on renal allograft survival. METHODS: Adult renal allograft recipients with primary glomerulonephritis were enrolled. Transplantation date was from Feb 2004 to Dec 2015. Exclusion criteria included combined organ transplantation, structural abnormality, diabetic nephropathy, hypertension nephropathy, obstructive nephropathy, and primary uric acid nephropathy...
October 2018: Transplantation Proceedings
Jae-Hyung Chang, S Ali Husain, Dominick Santoriello, Michael B Stokes, Clifford D Miles, Kirk W Foster, Yifu Li, Leigh-Anne Dale, Russell J Crew, David J Cohen, Krzysztof Kiryluk, Ali G Gharavi, Sumit Mohan
The presence of 2 APOL1 risk variants (G1/G1, G1/G2, or G2/G2) is an important predictor of focal segmental glomerulosclerosis (FSGS) and chronic kidney disease in individuals of African descent. Although recipient APOL1 genotype is not associated with allograft survival, kidneys from deceased African American donors with 2 APOL1 risk variants demonstrate shorter graft survival. We present a series of cases of presumed de novo collapsing FSGS in 5 transplanted kidneys from 3 deceased donors later identified as carrying 2 APOL1 risk alleles, including 2 recipients from the same donor whose kidneys were transplanted in 2 different institutions...
July 25, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jonathan H Pelletier, Karan R Kumar, Rachel Engen, Adam Bensimhon, Jennifer D Varner, Michelle N Rheault, Tarak Srivastava, Caroline Straatmann, Cynthia Silva, T Keefe Davis, Scott E Wenderfer, Keisha Gibson, David Selewski, John Barcia, Patricia Weng, Christoph Licht, Natasha Jawa, Mahmoud Kallash, John W Foreman, Delbert R Wigfall, Annabelle N Chua, Eileen Chambers, Christoph P Hornik, Eileen D Brewer, Shashi K Nagaraj, Larry A Greenbaum, Rasheed A Gbadegesin
BACKGROUND AND OBJECTIVES: Steroid-resistant nephrotic syndrome (SRNS) due to focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) is a leading cause of end-stage kidney disease in children. Recurrence of primary disease following transplantation is a major cause of allograft loss. The clinical determinants of disease recurrence are not completely known. Our objectives were to determine risk factors for recurrence of FSGS/MCD following kidney transplantation and factors that predict response to immunosuppression following recurrence...
October 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Parnaz Daneshpajouhnejad, Erfan Behzadi, Sanaz Amoushahi, Ahmadreza Aghabozorgi, Aida Farmani, Sayed-Mohsen Hosseini, Diana Taheri
Native kidney biopsy reports in previous studies that are mostly originated in Western countries show various results in different parts of the world. In this study, we aimed to determine the prevalence of renal biopsy disorders in Iran and compare it with that of other studies in the world. This cross-sectional study evaluated consecutive native kidney biopsies performed in four centers in Isfahan, Iran, from 2009 to 2014. We also reviewed other relevant studies in Iran and the world. Overall, 1547 renal biopsies were reviewed; 493 cases were excluded (transplant or re-biopsy cases) and 1054 cases (43...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Izumi Yamamoto, Takafumi Yamakawa, Ai Katsuma, Mayuko Kawabe, Haruki Katsumata, Aki Mafune Hamada, Yasuyuki Nakada, Akimitsu Kobayashi, Hiroyasu Yamamoto, Takashi Yokoo
The extent of recurrence of original kidney disease after kidney transplantation has been underestimated for several reasons. First, the duration of observation varies among studies. Second, the criteria used to schedule protocol and episode biopsies differ among institutions. And third, diagnostic modalities used for early detection of recurrent original kidney disease also vary. Thus, rates of graft loss attributable to a recurrence of original kidney disease vary among institutions and are often underestimated...
July 2018: Nephrology
Katrin Kienzl-Wagner, Alejandra Rosales, Stefan Scheidl, Thomas Giner, Claudia Bösmüller, Michael Rudnicki, Rupert Oberhuber, Christian Margreiter, Afschin Soleiman, Dietmar Öfner, Siegfried Waldegger, Stefan Schneeberger
Primary focal segmental glomerulosclerosis (FSGS) recurs in up to 55% of patients after kidney transplantation. Herein we report the successful management of recurrent FSGS. A 5-year-old boy with primary FSGS received a deceased donor renal transplant. Immediate and fulminant recurrence of FSGS caused anuric graft failure that was resistant to plasmapheresis and rituximab. After exclusion of structural or immunologic damage to the kidney by repeated biopsies, the allograft was retrieved from the first recipient on day 27 and transplanted into a 52-year-old second recipient who had vascular nephropathy...
November 2018: American Journal of Transplantation
Tarek Alhamad, John Manllo Dieck, Usman Younus, Dany Matar, Sami Alasfar, Vikas Vujjini, Devin Wall, Bilal Kanawati, Reiser Jochen, Daniel C Brennan, Nada Alachkar
BACKGROUND: Treatment of focal segmental glomerular sclerosis (FSGS) after kidney transplantation is challenging with unpredictable outcomes. The objective was to investigate the use of adrenocorticotropic hormone (ACTH) analogue gel in kidney transplant recipients with de novo or recurrent FSGS resistant to therapeutic plasma exchange and/or rituximab. METHODS: We performed a retrospective review of cases of de novo or recurrent resistant FSGS at 2 large U.S. transplant centers between April 2012 and December 2016...
June 12, 2018: Transplantation
Kirk N Campbell, James A Tumlin
BACKGROUND: Focal segmental glomerulosclerosis (FSGS) is a histologic pattern of injury demonstrated by renal biopsy that can arise from a diverse range of causes and mechanisms. It has an estimated incidence of 7 per 1 million and is the most common primary glomerular disorder leading to end-stage renal disease in the United States. This review focuses on damage to the podocyte and the consequences of this injury in patients with FSGS, the genetics of FSGS, and approaches to treatment with a focus on the effects on podocytes...
2018: American Journal of Nephrology
Irshad Ali Bajeer, Sabeeta Khatri, Veena Tresa, Seema Hashmi, Mohammed Mubarak, Ali Asghar Lanewala
OBJECTIVE: To determine the short-term outcome of cyclophosphamide (CPO) course in children with relapsing steroid sensitive nephrotic syndrome (SSNS) with different histopathological lesions. STUDY DESIGN: Descriptive, observational study. PLACE AND DURATION OF STUDY: Pediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2012 to December 2014. METHODOLOGY: All children with relapsing steroid-sensitive nephrotic syndrome, who underwent renal biopsy and received cyclophosphamide therapy, were included and followed up for 2 years...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Akihito Sannomiya, Toru Murakami, Ichiro Koyama, Kosaku Nitta, Ichiro Nakajima, Shohei Fuchinoue
Background: Focal segmental glomerulosclerosis (FSGS) often develops rapidly and frequently progresses to renal failure, while the recurrence rate after kidney transplantation is 20-50%. We performed low-density lipoprotein (LDL) apheresis before kidney transplantation in FSGS patients to prevent recurrence. Methods: Five adult patients with chronic renal failure due to FSGS undergoing living related donor kidney transplantation were investigated retrospectively...
2018: Journal of Transplantation
Yumeng Wen, Sapna Shah, Kirk N Campbell
Focal segmental glomerulosclerosis (FSGS) is the most common primary glomerular disease resulting in end-stage renal disease in the USA and is increasing in prevalence worldwide. It is a diverse clinical entity with idiopathic, genetic, metabolic, infectious, and other causes that culminate in a characteristic histologic pattern of injury. Proteinuria is a hallmark of FSGS as well as other primary and secondary glomerular disorders. The magnitude of proteinuria at disease onset and during treatment has prognostic implications for renal survival as well as associated cardiovascular morbidity and mortality...
2018: Frontiers in Medicine
R Shahbazov, M Talanian, J L Alejo, F Azari, A Agarwal, K L Brayman
Introduction: Encapsulating peritoneal sclerosis (EPS) is a clinical syndrome of progressive fibrotic change in response to prolonged, repetitive, and typically severe insult to the peritoneal mesothelium, often occurring in the setting of peritoneal dialysis (PD). Clear guidelines for successful management remain elusive. We describe the successful surgical management of EPS in a 28-year-old male s/p deceased donor kidney transplant for end-stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS)...
2018: Case Reports in Surgery
Anna Francis, Madeleine Didsbury, Hugh McCarthy, Tonya Kara
Disease recurrence affects around a third of renal transplants for children with FSGS and is associated with poor graft outcomes. Unfortunately, there are no large trials guiding treatment for recurrent FSGS. We aimed to describe current therapies and treatment response for recurrent FSGS in 4 centres in Australia and New Zealand. Data were collected on children (age <18 years) with recurrent FSGS (1990-2015). We reviewed patient charts to obtain clinical information. Ethics approval was obtained from the relevant boards...
August 2018: Pediatric Transplantation
Paloma L Martin-Moreno, Jose Rifon, Pedro Errasti
BACKGROUND/AIMS: We present a case of a male patient with severe recurrence of focal and segmental glomerulosclerosis (FSGS) after transplant. METHODS: Before the transplant he was treated with plasma exchange. Massive proteinuria was detected post-transplantation and plasma exchanges were performed without response. We administered 5 doses of Rituximab (375 mg/m2) and partial remission was achieved. Proteinuria relapse occurred 1 year post-transplant, so Immunoadsorption (IA) was started instead of plasma exchange with reduction of proteinuria...
2018: Blood Purification
Nicola Lepori, Ladan Zand, Sanjeev Sethi, Gema Fernandez-Juarez, Fernando C Fervenza
Focal segmental glomerulosclerosis (FSGS) is a histologic lesion resulting from a variety of pathogenic processes that cause injury to the podocytes. Recently, mutations in more than 50 genes expressed in podocyte or glomerular basement membrane were identified as causing genetic forms of FSGS, the majority of which are characterized by onset in childhood. The prevalence of adult-onset genetic FSGS is likely to be underestimated and its clinical and histological features have not been clearly described. A small number of studies of adult-onset genetic FSGS showed that there is heterogeneity in clinical and histological findings, with a presentation ranging from sub-nephrotic proteinuria to full nephrotic syndrome...
April 2018: Clinical Kidney Journal
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