Regional secondary focal segmental glomerulosclerosis in a transplanted kidney : resolution with treatment of a segmental renal artery stenosis
| Autor: | Toshimori Seki, Yuichiro Fukasawa, Masaki Togashi, Hiroaki Usubuchi, Hiroshi Harada, Kiyohiko Hotta, Daiki Iwami |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Nephrology
Male medicine.medical_specialty Renal Artery Obstruction Urology Nephrotic syndrome Case Report lcsh:RC870-923 Renal artery stenosis urologic and male genital diseases Kidney transplantation Internal medicine medicine Humans Transplantation Homologous Secondary FSGS (focal segmental glomerulosclerosis) Kidney business.industry urogenital system Glomerulosclerosis Focal Segmental Graft Survival food and beverages Glomerulosclerosis Middle Aged lcsh:Diseases of the genitourinary system. Urology medicine.disease Secondary Focal Segmental Glomerulosclerosis female genital diseases and pregnancy complications medicine.anatomical_structure Treatment Outcome Cardiology sense organs business |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 13, Iss 1, p 38 (2012) |
| ISSN: | 1471-2369 |
| Popis: | Background Conditions associated with high intraglomerular filtration pressure can cause secondary focal segmental glomerulosclerosis (FSGS). Unilateral renal artery stenosis (RAS) or its occlusion results in FSGS-like changes and the nephrotic syndrome in the contralateral kidney due to hyperfiltration. However, it has been rarely reported that stenosis of a renal arterial branch can result in FSGS-like changes in a different portion in the same kidney allograft. Case presentation A 60-year-old male kidney recipient developed allograft dysfunction after angiotensin II receptor blockade for hypertension 4 months after transplantation. It was proven that one of two arterial branches of the graft was markedly stenotic. Graft dysfunction improved after percutaneous transluminal arterioplasty (PTA), however; the stenosis recurred and massive proteinuria developed 5 months later. Graft biopsy showed ischemic changes in the region fed by the stenotic artery branch and in contrast FSGS-like changes in the region fed by the other branch. His clinicopathological manifestation including massive proteinuria almost normalized after the repeat PTA. Conclusion Here we report a case of secondary FSGS of a kidney allograft due to severe RAS of a branch of the same kidney, in which clinical and pathological improvement were confirmed after radiological intervention. When moderate to severe proteinuria appear, secondarily developed FSGS as well as primary (recurrent or de novo) FSGS should be taken into account in kidney transplant recipients. |
| Databáze: | OpenAIRE |
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