Recurrence of focal segmental glomerulosclerosis posttransplantation: a special report of the North American Pediatric Renal Transplant Cooperative Study.
Among various forms of glomerulonephritis, focal segmental glomerulosclerosis (FSGS) is the most common cause of end-stage renal disease leading to transplantation in children. Previous reports of the recurrence of FSGS vary widely. The North American Pediatric Renal Transplant Cooperative Study carried out a special study to determine the rate of recurrence and risk factors leading to recurrence in 132 transplants. Fifty-five percent of the patients were white children, and the remaining were black and Hispanic children. Fifty percent of the patients were under 5 yr of age at the time of the diagnosis of FSGS. Twenty-seven (20.5%) of 132 patients (95% confidence interval, 14 to 27) had a biopsy-proven recurrence of FSGS. The median time to recurrence was 14 days. The recurrence rate was similar in white children (23%) when compared with that in Hispanic children (20%) but was lower than that in black children (9%) (3 of 32 children).2+ (20%). The mean serum albumin level of patients with recurrence was 1.7 versus 2.0 g/dL for those without recurrence. The mean serum cholesterol level of patients with recurrence was 525 versus 476 mg/dL for those without recurrence. The duration of dialysis was similar in the two groups. The mean time from diagnosis to end-stage renal disease status was 33 months for patients with recurrence and 52 months for those without recurrence (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Tejani
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SUNY Health Science Center, Brooklyn 11203-2098.
Stablein
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D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D015993:Life Tables; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology