ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2157

Clinical Characteristics and Outcomes of FSGS in Kidney Transplant Recipients: A Single-Center Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Pop, Anne Marie, Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, United States
  • Valdes, Jose Luis, Henry Ford Health System, Detroit, Michigan, United States
  • Prashar, Rohini, Henry Ford Health System, Detroit, Michigan, United States
Background

Focal segmental glomerular sclerosis (FSGS) is a common etiology of chronic kidney disease in adults. Many progress to end stage renal disease requiring dialysis initiation and/or renal transplantation. It is also known to recur in transplantation, however there is limited literature addressing treatment options and outcomes in these patients. The purpose of this study is to evaluate clinical characteristics and post-transplant outcomes in kidney transplant recipients (KTRs) with primary and secondary FSGS.

Methods

This is a single-center retrospective study where data was collected from November of 2014 to December of 2020 on all KTRs with the diagnosis of FSGS within the Henry Ford Health System in Detroit, MI.

Results

A total of 39 KTRs were studied. 28% had primary FSGS and 71% had secondary. Baseline characteristics of KTRs can be found in table 1. 5 had recurred and all had primary disease. Recurrence was suggested by worsening proteinuria (>3.5g/day), and/or albumin <3.5 g/dL, and confirmed by renal biopsy. Median time of recurrence was 24 months post-transplant. Median proteinuria at time of diagnosis was 5.6 g. 3 that recurred were African American, 1 was Caucasian and 1 was Indian. A total of 4 out of 5 were treated with plasmapheresis. 2 had complete remission which was defined by reduction in proteinuria to <300 mg/day. One who did not achieve remission continues to have stable allograft function with ongoing proteinuria and the other had allograft loss at 96 months. None experienced adverse effects from treatment.

Conclusion

Recurrence of FSGS is more prevalent in patients with primary disease. Response to treatment is associated with significantly better outcomes and complete remission was achieved in 50% of cases.

Table 1
Baseline CharacteristicsPrimarySecondary
Number of patients (total)11 (28.2%)28 (71.7%)
Recurrence (# pt)50
Age at diagnosis (yr)33 (22-62)34 (19-72)
Age at transplantation (yr)35.5 (25-65)45 (24-77)
Male sex7 (63.6%)22 (75.8%)
BMI30 (20-37)30 (20-42)
African American5 (12.8%)8 (20.5%)
Caucasian4 (10.2%)15 (38.4%)
Time of diagnosis to ESKD (mo)48 (0-144)48 (0-228)