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Main > Kidney Disease > FSGS > FSGS Basics >
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Patient Experience—FSGS Relapses after Kidney Transplantation

2012-12-13 09:15

Brief introduction of patients’ illness condition:

John Deer, Male, 21 years old, edema and abdominal distension attack 4 months after kidney transplantation in 2005.

John received kidney transplant in June 2005 due to his ESRD (End-stage Renal Disease). His End-stage Renal Failure is caused by FSGS (Focal Segmental Glomerulosclerosis). The surgery went smoothly and the patient recovered well. Immunosuppressants have been adopted after the surgery. John’s serum creatinine came back to normal 7 days after the surgery. However, protein in urine presents positive by urinalysis three days later, quantitative testing for urine protein fluctuates between 2-4g/24hr, no edema.

Lab tests:

Blood tests: Hb: 113g/L, WBC: 5.8×109/L, Plt: 142×109/L

Urinalysis: 24 hour urinary protein quantity: 7.71g/1400ml, NAG enzyme: 4.1U/g·cr

Other test results: albumin: 19.6g/L, globulin: 20.6g/L, BUN: 12.6mmol/L, SCr: 114µmol/L, urine acid: 486µmol/L, cholesterol: 9.23mmol/L

Immunofluorescence: IgG, IgA presents negative, IgM+ and C3+ spread in glomerular mesangial area.

Diagnosis: FSGS relapses

Analysis of John’s illness condition:

The patient developed massive albuminuria 3 days after kidney transplantation but his kidney function recovers well at first.

The pathological changes of kidney biopsy meet up with FSGS

Other than IgM+ and C3+ show positive, others present negative. Capillaries around renal tubulus present C4d negative.

All those factors above don’t meet up with acute rejection response. That’s how we diagnose the relapse.

Focal Segmental Glomerulosclerosis is one of the easiest primary glomerulonephritis in clinic, and it is believed that FSGS patients have an earlier relapse time compared with any other diseases. Meanwhile, its recurrence rate is the highest. Proteinuria becomes an early indicator of relapse.

Risk factors of recurrent Focal Segmental Glomerulosclerosis including:

Young patients, especially those whose onset is less than 15 years old

The disease progresses quickly, normally progresses to ESRF within 3 years.

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Tag: FSGS FSGS Basics

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