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Gonzalo Ramirez-Guerrero Angel M Sevillano Prieto Fernando Jara-Vilugrón Natalia Polanco Fernandez Esther Gonzalez Monte Ana Henandez Vicente Lucia C Rodriguez Gayo Manuel Praga Terente Amado Andrés Belmonte 《Transfusion and apheresis science》2021,60(2):103046
The recurrence of primary focal segmental glomerulosclerosis (FSGS) after kidney transplantation (KT) appears in 30 % of the recipients. Sometimes it can cause the loss of the allograft. Although many treatments for this condition have been reported, 20 %–40 % of the affected patients are refractory or presents frequents relapses. In this paper we describe the evolution of three recipients treated with long-term plasmapheresis therapy after a recurrence of FSGS with a bad or incomplete response to other treatments. Although our findings require confirmation, long-term plasmapheresis could be a therapeutic option for this condition. 相似文献
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Mary Carmelle Philogene Sheng Zhou Bonnie E. Lonze Serena Bagnasco Sami Alasfar Robert A. Montgomery Edward Kraus Annette M. Jackson Mary S. Leffell Andrea A. Zachary 《Human immunology》2018,79(4):195-202
Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transplant recipients who may benefit from screening for non-HLA antibodies. Kidney recipients transplanted between 2011 and 2016 at Johns Hopkins, were evaluated for AT1R-Ab and AECA. Pre-transplant antibody levels were compared to clinical and biopsy indications of graft dysfunction. Biopsies were graded using the Banff' 2009–2013 criteria. AT1R-Ab and AECA were detected using ELISA and endothelial cell crossmatches, respectively. AT1R-Ab levels were higher in patients who were positive for AECAs. Re-transplanted patients (p?<?0.0001), males (p?=?0.008) and those with FSGS (p?=?0.04) and younger (p?=?0.04) at time of transplantation were more likely to be positive for AT1R-Ab prior to transplantation. Recipients who were positive for AT1R-Ab prior to transplantation had increases in serum creatinine within 3?months post-transplantation (p?<?0.0001) and developed abnormal biopsies earlier than did AT1R-Ab negative patients (126?days versus 368?days respectively; p?=?0.02). Defining a clinical protocol to identify and preemptively treat patients at risk for acute rejection with detectable non-HLA antibodies is an important objective for the transplant community. 相似文献
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Musab S. Hommos An S. De Vriese Mariam P. Alexander Sanjeev Sethi Lisa Vaughan Ladan Zand Kharmen Bharucha Nicola Lepori Andrew D. Rule Fernando C. Fervenza 《Mayo Clinic proceedings. Mayo Clinic》2017,92(12):1772-1781
Objectives
To describe the change in the incidence rates of primary and secondary focal segmental glomerulosclerosis (FSGS) from 1994 through 2013 in Olmsted County, Minnesota, and to identify the clinical and biopsy characteristics that distinguish primary from secondary FSGS.Patients and Methods
Olmsted County adult residents with native kidney biopsy from January 1, 1994, through December 31, 2013, and FSGS as the only glomerulopathy were identified. The clinical and pathologic characterstics of primary and secondary FSGS were described and compared, and incidence rates were calculated.Results
Of 370 adults biopsied, 281 had glomerular diseases, of which 46 (16%) had FSGS. From 1994-2003 to 2004-2013, there were significant increases in kidney biopsy rates (14.7 [95% CI, 12.1-17.3] vs 22.9 [95% CI, 20.0-25.7] per 100,000 person-years, 17% increase per 5 years; P<.001) and total FSGS rates (1.4 [95% CI, 0.6-2.2] vs 3.2 [95% CI, 2.1-4.3] per 100,000 person-years, 41% increase per 5 years; P=.02). Compared with patients with limited foot process effacement (<80%), patients with diffuse effacement (≥80%) without an identifiable cause had lower serum albumin levels (P<.001), had higher proteinuria (P<.001), and were more likely to have nephrotic syndrome (100% vs 4%; P<.001). Patients with diffuse effacement without an identifiable cause were classified as primary FSGS, which accounted for 3 of 12 patients (25%) during 1994-2003 and 9 of 34 (26%) during 2004-2013.Conclusion
Although the incidence of FSGS has increased, the proportions of primary and secondary FSGS have remained stable. 相似文献7.
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Brandon Ginley Kuang-Yu Jen Seung Seok Han Luís Rodrigues Sanjay Jain Agnes B. Fogo Jonathan Zuckerman Vighnesh Walavalkar Jeffrey C. Miecznikowski Yumeng Wen Felicia Yen Donghwan Yun Kyung Chul Moon Avi Rosenberg Chirag Parikh Pinaki Sarder 《Journal of the American Society of Nephrology : JASN》2021,32(4):837