A single-center, retrospective study of Focal segmental glomerulosclerosis after Kidney Transplantation: Evolutive analysis

Gustavo Ferreira da Mata, Juliana Mansur, Michelle Tiveron Passos Riguetti, Gabriel Ferreira Rezende, José Osmar Medina de Abreu Pestana, Gianna Mastroianni Kirsztajn

Abstract


Introduction: Focal segmental glomerulosclerosis (FSGS) has a high recurrence rate after renal transplantation, which significantly impacts renal graft survival. However, the factors related to recurrence remain unclear. Objectives: This study aimed to analyze the focal segmental recurrence and evolution of glomerulosclerosis after renal transplantation. Methods: This was a descriptive, retrospective study involving 88 adults who underwent renal transplantation within a 15-year period. Demographic and clinical characteristics, as well as the occurrence of graft loss, were analyzed. Over the study period, 88 patients with a diagnosis of FSGS after transplantation were identified. Results: The mean age of the patients (male,54) was 29.1 years. Transplants with deceased donors predominated (60.9%). Calcineurin and prednisone inhibitors were present in 96.4% of the initial immunosuppression regimens. The mean time of onset of proteinuria greater than 0.5 g/g was 20.51 days. At 60 months after transplantation, 44.16% of the patients had partial remission, 25.97% had complete remission, and 29.87% had no remission. However, 50.60% of the patients developed graft loss throughout the analyzed period. Eight patients (9.4%) died within 60 months, of which five (62.5%) were attributed to infection. Conclusions: Our results indicate that FSGS after renal transplantation is a disease of high recurrence that is commonly precocious, and the histological alterations in light microscopy are not simultaneous to the appearance of proteinuria. Hypertension is considered a risk factor causing progression and recurrence. Thus, prospective studies are required to better evaluate progression and recurrence factors.


Keywords


Focal segmental glomerulosclerosis; transplantation; graft loss; systemic arterial hypertension

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 pISSN: 2008-6482
 eISSN: 2008-6490

 

Creative Commons LicenseThis work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License