TITLE

378. Remission of nephrotic syndrome is not uncommon

AUTHOR(S)

Truong, L.D.; Baranowska-Daca, B.; Ly, P. Danh Cong

PUB. DATE

May 2003

SOURCE

Kidney;May/Jun2003, Vol. 12 Issue 3, p137

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Objective: To evaluate comprehensively the pathological and clinical features of reversible posttransplant nephrotic syndrome (NS) and its impact on the graft. Methodology: Records of the 477 renal transplant recipients during a 12-year period between 1988 and 2000 were reviewed to identify those with posttransplant NS. Results: Among 67 renal transplant recipients with NS, nine episodes were reversible in eight patients. Biopsies showed minimal-change disease (n = 4), focal segmental membranous glomerulonephritis, and acute glomerulitis (n = 1), [gA nephropathy and acute glomerulitis (n = ) or thrombotic microangiopathy (n = 1), and chronic transplant nephropathy with (n = 1 ) or without acute glomerulitis (n = 1). NS developed 1-4 months posttransplant in the four patients with minimal-change disease, but later (33-151 months) in the others. At onset, serum creatinine was normal or elevated. Treatment included calcium channel blockers, angiotensinconverting enzyme inhibitors, or both, together with routine antirejection therapy. Remission was achieved 4-12 months after onset, when renal function remained normal in four, improved in four, and worsened in one. At last follow-up, six patients still had remission and functional grafts. One lost the graft to chronic transplant nephropathy while NS remained in remission. In the remaining patient, proteinuria, which was due to chronic transplant glomerulopathy unrelated to the initial minimal-change disease associated NS, recurred 50 months posttransplant. Remission of posttransplant NS is possible. It is often associated with minimal-change diseases and less frequently with other glomerular lesions, including acute glomerulitis. Reversible posttransplant NS does not have...

ACCESSION #

10145971

Tags: NEPHROTIC syndrome;  KIDNEYS -- Transplantation;  GRAFT rejection;  CREATININE;  GLOMERULONEPHRITIS

 

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