Factors Associated with Response to Plasmapheresis in Patients with Recurrent FSGS.
1Department of Medicine, Division of Nephrology, University of California-San Francisco, California, CA
2Department of Medicine, Division of Nephrology, New York University, New York, NY
3Department of Sociology, George Washington University, Washington, DC
4Transplant Surgery, Piedmont Transplant Institute, Atlanta, GA.
Meeting: 2016 American Transplant Congress
Abstract number: D236
Keywords: Glomerulonephritis, Kidney transplantation, Plasmapheresis, Recurrence
Session Information
Session Name: Poster Session D: Poster Session II: Kidney Complications-Other
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background:
Idiopathic focal segmental glomerulosclerosis (FSGS) is one of the primary glomerular diseases that commonly recurs in renal allograft and is known to be associated with poor allograft survival. Plasmapheresis (PP) is the mainstay treatment for recurrent FSGS. However, factors that may predict response to PP is not well characterized. We reviewed patients transplanted between 1991 to 2013 at our center who were diagnosed with recurrent FSGS.
Methods:
38 patients (median age, 42 years; 52% male) were identified as having recurrent FSGS in their renal allograft by rise in proteinuria with biopsy-proven recurrent FSGS (33/38). All patients received 9 sessions of PP. Full remission was defined as achieving urine protein to creatinine ratio of less than or equal to 0.5 grams per gram, partial remission as decrease in urine protein to creatinine ratio by at least 50 percent after treatment, and treatment failure as persistently elevated urine protein to creatinine ratio of 50 percent or above the initial value during the three months after receiving PP. Baseline characteristics including age, sex, race, type of transplant, induction agent, maintenance regimen, serum creatinine, and quantification of proteinuria were compared between the different response groups using ANOVA and chi-square tests. Patients were followed for up to 24 years.
Results:
Full remission was achieved in 22 patients (58%), partial remission in 9 patients (24%), and treatment failure in 7 patients (18%). Use of interleukin-2 (IL-2) receptor blockers (p =0.001) and higher serum creatinine level at time of diagnosis of recurrent FSGS (p=0.0889) were associated with response to PP. Age, gender, race, type of transplant, maintenance therapy regimen, time to recurrence of FSGS, and level of proteinuria at time of diagnosis were not found to be predictors of response to therapy.
Conclusion:
In the group studied, the use of IL-2 receptor blockers for induction and higher level of serum creatinine at time of diagnosis were associated with full or partial response of recurrent FSGS to plasmapheresis.
CITATION INFORMATION: Shoji J, Tatapudi V, Laszik Z, Jones A, Wolf J, Adey D, Vincenti F. Factors Associated with Response to Plasmapheresis in Patients with Recurrent FSGS. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Shoji J, Tatapudi V, Laszik Z, Jones A, Wolf J, Adey D, Vincenti F. Factors Associated with Response to Plasmapheresis in Patients with Recurrent FSGS. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-associated-with-response-to-plasmapheresis-in-patients-with-recurrent-fsgs/. Accessed May 20, 2025.« Back to 2016 American Transplant Congress