Current approaches to overcome recurrent focal segmental glomerulosclerosis after kidney transplantation.

Syeda Behjat Ahmad, Yonatan Peleg, Wooin Ahn

Journal: Current opinion in nephrology and hypertension 2023;33(1):61-66

PMID: 37921337

Abstract

PURPOSE OF REVIEW

Recurrent focal segmental glomerulosclerosis (FSGS) presents with nephrotic syndrome shortly after kidney transplantation. This review will overview the role of circulating permeability factors in disease pathogenesis and treatment options for recurrent FSGS.

RECENT FINDINGS

Novel circulating permeability factors have been identified in serum samples. Current research is focused on detection of permeability factors as a marker of treatment response. Furthermore, novel monoclonal antibodies are being utilized to further induce remission.

SUMMARY

Posttransplant recurrent FSGS can have a deleterious effect on allograft. Early detection of disease recurrence with prompt treatment is optimal for clinical remission. Plasmapheresis with anti-B cell therapy is considered the mainstay of treatment. Newer B cell therapies and detection of circulating factors in serum may help in providing targeted treatment in a subset of patients.

Address: University of Pittsburgh School of Medicine, Division of Renal-Electrolyte, Pittsburgh, Pennsylvania.; Northwestern University Feinberg School of Medicine, Division of Nephrology and Hypertension, Chicago, Illinois.; Oregon Health & Science University School of Medicine, Division of Nephrology and Hypertension, Portland, Oregon, USA.

DOI: 10.1097/MNH.0000000000000946

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MeSH Terms: Humans, Glomerulosclerosis, Focal Segmental, Kidney Transplantation, Nephrotic Syndrome, Antibodies, Monoclonal, Plasmapheresis, Recurrence