Impact of recurrent nephrotic syndrome after renal transplantation in young patients
| Autor: | Otto Mehls, J. Fydryk, Elke Wühl, M. Wiesel, Franz Schaefer, Karl Schärer |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Nephrotic Syndrome Adolescent Drug Resistance Kidney Focal segmental glomerulosclerosis Recurrence Internal medicine Cyclosporin a medicine Humans Child Plasma Exchange Glomerulosclerosis Focal Segmental business.industry Graft Survival Glomerulonephritis Prognosis medicine.disease Kidney Transplantation Surgery Transplantation Child Preschool Pediatrics Perinatology and Child Health Cyclosporine Kidney Failure Chronic Female Steroids business Complication Nephrotic syndrome Immunosuppressive Agents Kidney disease |
| Zdroj: | Pediatric Nephrology. 12:529-533 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s004670050499 |
| Popis: | Recurrent disease is a frequent complication of patients transplanted for steroid-resistant nephrotic syndrome associated with focal segmental glomerulosclerosis. Its long-term prognosis has rarely been studied. We examined 39 patients aged 4-25 (mean 13.5) years at the time of first transplantation (TX). Twelve of these (30%) developed nephrotic syndrome after the first TX and 2 of 8 after the second TX. The mean observation period from first TX to last observation with a functioning graft or graft loss was 5.4 (0.1-19.3) years. We confirmed that recurrent disease is associated with older age at onset of the primary disease, shorter time from onset to end-stage renal disease, and diffuse mesangial proliferation in the initial kidney biopsy. Remissions occurred in all 3 children undergoing early repeated plasma exchange and in 1 adolescent following introduction of cyclosporin A 7 years after TX. At last observation 42% of relapsing and 48% of non-relapsing patients with a similar follow-up period had a functioning first graft. Median first graft survival was almost identical in the relapsing and the non-relapsing patients (4.3 vs. 4.2 years). Histological lesions of focal glomerulosclerosis were detected in the posttransplant biopsies of only 3 patients. In conclusion, young patients with nephrotic syndrome associated with focal segmental sclerosis have a similar graft survival with and without recurrence of the nephrotic syndrome. |
| Databáze: | OpenAIRE |
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