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Abstract: TH-PO142

Overweight and Size Mismatch Are Risk Factors of De Novo Focal Segmental Glomerulosclerosis After Kidney Transplantation from Parent to Child

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Suzuki, Tomo, St Marianna University Hospital, Kawasaki, Japan
  • Yazawa, Masahiko, St Marianna University Hospital, Kawasaki, Japan
  • Ichikawa, Daisuke, St Marianna University Hospital, Kawasaki, Japan
  • Imai, Naohiko, St Marianna University Hospital, Kawasaki, Japan
  • Sasaki, Hideo, Department of Urology, St. Marianna university school of medicine, Kawasaki, Japan
  • Marui, Yuhji, Department of Urology, St. Marianna university school of medicine, Kawasaki, Japan
  • Koike, Junki, St.Marianna University, Kawasaki, Kanagawa, Japan
  • Shibagaki, Yugo, St Marianna University Hospital, Kawasaki, Japan
Background

Proteinuria among transplant recipients is an important factor for allograft and patient survival. In addition, the mean age of donor is increasing in Japan. The aging donor is a risk factor of de novo focal segmental glomerulosclerosis (FSGS) due to podocytopenia and loss of nephron number. The aim of this study is to evaluate the risk factor in de novo FSGS after kidney transplantation (KTx) from parent to child.

Methods

This is an observational case control study. The subjects were 45 patients who underwent KTx from parent to child between 2009 Apr to 2016 Aug in our Hospital and whose allograft survived to have allograft biopsy not showing FSGS at both 0 and 12 months. Cases of recurrent FSGS (N=1), IgA nephropathy (N=1), and nephrosclerosis of 0h biopsy (N=1) and those without protocol biopsy at 12 months (N=3) were excluded, leaving total of 39 patients. We examined clinical and histological features, with all values are expressed as mean ± standard error (SE).

Results

Five out of 39 recipients showed FSGS in biopsy which was done after > 12 months (FSGS group). Comparing FSGS group vs non-FSGS group, male accounted for 100% vs 61.8 %, the ages were 41.2 ± 3.3 vs 35.0 ± 1.3 (p=0.088), body weight (BW)were 74.9 ± 6.1 vs 59.5 ± 2.4 kg (P=0.024), body mass index (BMI) were 26.2 ± 2.0 vs 21.9 ± 0.8 kg/m2(P = 0.049), the donor age was 68.8 ± 3.2 vs 62.4 ± 1.2 (p=0.069), and the donor eGFR was 72.3 ± 6.2 vs 77.6 ± 2.4 ml/min/1.73m2, respectively. So, there were significant differences for BW and BMI of recipients. Before KTx, the difference between the recipient and donor’s BW was significantly higher in FSGS group [18.3 ± 7.3 vs 1.4 ± 2.8 kg (p=0.038)]. At protocol biopsy of 12 months after KTx, BW and BMI in FSGS group were also significantly higher than non-FSGS group [ BW; 78.0 ± 6.1 vs 60.6 ± 2.3 kg (P=0.012), BMI; 27.3 ± 1.9 vs 22.3 ± 0.8 kg (P=0.027)]. The duration to FSGS diagnosis after KTx was 1066 ± 277 day. The Columbia classification of FSGS group was all NOS variant (no perihilar). The range of foot process effacement was not diffuse, indicating these FSGS were secondary.

Conclusion

Overweight of the recipient and size mismatch are risk factors of de novo FSGS after 12 months post-KTx from parent to child.