Diagnosis and treatment of focal segmentalglomerulosclerosis after kidney transplantation in children
10.3760/cma.j.issn.0254-1785.2020.02.003
- VernacularTitle:儿童肾移植术后局灶性节段性肾小球硬化六例诊治报道并文献复习
- Author:
Weijian NIE
1
;
Qian FU
;
Jun LI
;
Chenglin WU
;
Ronghai DENG
;
Xixi GAN
;
Wenfang CHEN
;
Lizhi CHEN
;
Ying MO
;
Xiaoyun JIANG
;
Longshan LIU
;
Changxi WANG
Author Information
1. 中山大学附属第一医院器官移植中心，广州 510080
- From:
Chinese Journal of Organ Transplantation
2020;41(2):70-74
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis and treatment of focal segmental glomerulosclerosis (FSGS) post-kidney transplantation in children.Methods:Clinical data were retrospectively analyzed for 6 FSGS children after transplantation from 2015 to 2019. Massive proteinuria (3.2-13 g/24 h) occurred at 4 days-49 days post-transplantation. For proteinuria, glucocorticoid plus therapeutic plasma exchange and/or rituximab were provided with supplemental ACEI/ARB drugs. Five cases received tacrolimus as maintenance therapy while another case had cyclosporin A as an initial intensive therapy and switched to tacrolimus.Results:Four cases achieved complete remission after therapy. One recipient showed partial remission. During a follow up period of 11 months to 4 years, serum creatinine remained normal and stable in five cases while one died from severe pulmonary infection.Conclusions:Once FSGS occurs post-transplantation, prompt treatment of pulse glucocorticoid plus therapeutic plasma exchange and/or rituximab with supplemental ACEI/ARB drugs may yield favorable outcomes.
