Background Recurrent focal segmental glomerulosclerosis(FSGS) is common after kidney transplantation . We conducted a retrospective cohort study with the aim to investigating the long-term outcome and risk factors of recurrent FSGS after kidney transplantation.

Method We retrospectively collected 92 kidney transplant recipients with FSGS as the primary disease from January 2000 to December 2011. The patients were followed up for at least 5 years. Baseline characteristics including age ,gender, proteinuria level, progress of primary FSGS were recorded. Proteinuria levels after transplant were monitored, and recurrent FSGS was diagnosed by allograft biopsy when proteinuria reappeared.

Results 34(37.0%) patients suffered recurrent FSGS after kidney transplantation, which was diagnosed by allograft biopsy. The median recurrent time was 26 months. Proteinuria was found in all patients with recurrent FSGS, and the mean proteinuria level was 4.21 g/ 24hours. Kaplan-Meier analysis showed that the 1-, 5-, and 10-year death censored graft survivals were much lower in recurrent FSGS recipients compared to non-recurrent FSGS recipients (97.1%, 47.1% and 28% vs. 100%, 87.9%, and 58.9%). The median survival time was much shorter in recurrent FSGS recipients than non-recurrent FSGS recipients (57 months vs. 142 months, p=0.0002). Logistic multivariate regression showed that young age (<18 years old), proteinuria more than 7g/24h before transplant, and rapid progress of primary FSGS(<3 year from onset to uremia) were independent risk factors for recurrent FSGS (p<0.05).

Conclusion Recurrent FSGS is common after kidney transplantation and prognosis is poor. Young age, heavy proteinuria before transplant, and rapid progress of primary FSGS are independent risk factors for recurrent FSGS.

CITATION INFORMATION: Chen G, Wang C, Wu Z, Zhang J, Yu S, Wang C, Qiu J, Chen L. Outcome and Risk Factors of Recurrent Focal Segmental Glomerulosclerosis After Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).

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