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What is the Outcome of FSGS after Kidney Transplant

2012-10-29 14:44

Focal Segmental Glomerulosclerosis (FSGS) is a pathological term to indicate glomerular lesions with specific clinical features. For people with FSGS, while trhe prognosis is relatively good if they have subnephrotic proteinuria, most people with massive and persistent proteinuria may progress into end-stage kidney disease, even if immunosuppressive medicine treatment is done. At kidney failure, kidney transplant may be taken into consideration as the treatment off choice. However, in FSGS, the outcome after transplant is not as positive because the disease tends to have a higher relapse rate as composed to other cases with ESRD.

What is the outcome for FSGS after kidney transplant? Recurrence of FSGS is associated with many factors, Young children, patients with mesangial proliferation in the native kidneys, those who had a progression to ESRD, and those who received pre-transplantation bilateral nephrectomy have been reported to have a higher risk of recurrence. There are two clinical presentations of FSGS after transplant. In an early recurrence, people have massive proteinuria within hours to days after the transplantation. A late recurrence may develop insidiously several months or years after transplantation.

FSGS is a kidney disorder that is associated to immune disorder. Immune abnormalities are deposited on the kidneys to activate immune damage on healthy functioning renal cells. Immunosuppressive medicine treatment on the patients helps to control the inflammation and relieve damage on the kidney cells. However, long-term use of immunosuppressants suppress immune system and increase risks of relapses. After kidney transplant, the patients will use immunosuppressive medicines to reduce rejection to the new kidneys, however, the immune disorder is not corrected and FSGS may get relapsed easily. In the first kidney allograft, 20 to 30 percent patients develop recurrence of FSGS. In second grafts, those who have had recurrence in the first graft, are generally accompanied by a further recurrence. Young people with FSGS and kidney failure may do several times of transplant. As for treating FSGS, the treatment should include improving damaged renal cells, regulating the immune system and correcting the immune disorder, which would help to stop progression and improve the illness condition. Combining traditional Chinese medicines with western medicines may help in improving the prognosis in FSGS people with kidney failure.


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