Edward J Nehus1, Jens W Goebel, Paul S Succop, Elizabeth C Abraham. 1. 1 Division of Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2 Division of Epidemiology & Biostatistics, University of Cincinnati, Cincinnati, OH. 3 Department of Pediatrics, Saint Louis University at Cardinal Glennon Children's Medical Center, St. Louis, MO. 4 Address correspondence to: Elizabeth C. Abraham, M.D., M.S., Division of Nephrology, SSM Cardinal Glennon Children's Medical Center, 1465 South Grand Boulevard, St. Louis, MO 63104.
Abstract
BACKGROUND: Focal segmental glomerulosclerosis (FSGS), the second leading cause of end stage renal disease in children, appears to be increasing. Moreover, posttransplantation FSGS recurrence is a major problem, and there is concern that children receiving kidneys from living donors (LD) have increased recurrence risk. METHODS: Data from the United Network for Organ Sharing from 1988 to 2008 were analyzed for number of de novo transplant recipients with a primary diagnosis of FSGS in children 1 to 20 years of age. Poisson regression was used for trend analysis. Univariate and multivariable logistic regression analyses were performed to examine the association of gender, race, human leukocyte antigen matching, age, and donor type with recurrence. RESULTS: Trend analysis of kidney transplantations for FSGS in children (n=2157) showed an increase in cases of 5.8% per year or 209% over 20 years (P<0.0001). Recurrence was reported in 327 (15%) cases overall, with a preponderance for white recipients (P<0.001) in younger age subgroups (P<0.01). Donor type was significant (P=0.02), with recurrence reported in 17% versus 14% of recipients of kidneys from LDs versus deceased donors. Using multivariate analysis, recipients' young age (P=0.02) and white race (P<0.001) were identified as significant risk factors for recurrence, whereas receiving a LD kidney became insignificant. CONCLUSIONS: FSGS as a cause of pediatric end-stage renal disease leading to transplantation is on the rise. FSGS recurrence is highest in young, white children, whereas receiving a LD kidney is not independently associated with increased risk of recurrence.
BACKGROUND: Focal segmental glomerulosclerosis (FSGS), the second leading cause of end stage renal disease in children, appears to be increasing. Moreover, posttransplantation FSGS recurrence is a major problem, and there is concern that children receiving kidneys from living donors (LD) have increased recurrence risk. METHODS: Data from the United Network for Organ Sharing from 1988 to 2008 were analyzed for number of de novo transplant recipients with a primary diagnosis of FSGS in children 1 to 20 years of age. Poisson regression was used for trend analysis. Univariate and multivariable logistic regression analyses were performed to examine the association of gender, race, human leukocyte antigen matching, age, and donor type with recurrence. RESULTS: Trend analysis of kidney transplantations for FSGS in children (n=2157) showed an increase in cases of 5.8% per year or 209% over 20 years (P<0.0001). Recurrence was reported in 327 (15%) cases overall, with a preponderance for white recipients (P<0.001) in younger age subgroups (P<0.01). Donor type was significant (P=0.02), with recurrence reported in 17% versus 14% of recipients of kidneys from LDs versus deceased donors. Using multivariate analysis, recipients' young age (P=0.02) and white race (P<0.001) were identified as significant risk factors for recurrence, whereas receiving a LD kidney became insignificant. CONCLUSIONS: FSGS as a cause of pediatric end-stage renal disease leading to transplantation is on the rise. FSGS recurrence is highest in young, white children, whereas receiving a LD kidney is not independently associated with increased risk of recurrence.
Authors: Jonathan H Pelletier; Karan R Kumar; Rachel Engen; Adam Bensimhon; Jennifer D Varner; Michelle N Rheault; Tarak Srivastava; Caroline Straatmann; Cynthia Silva; T Keefe Davis; Scott E Wenderfer; Keisha Gibson; David Selewski; John Barcia; Patricia Weng; Christoph Licht; Natasha Jawa; Mahmoud Kallash; John W Foreman; Delbert R Wigfall; Annabelle N Chua; Eileen Chambers; Christoph P Hornik; Eileen D Brewer; Shashi K Nagaraj; Larry A Greenbaum; Rasheed A Gbadegesin Journal: Pediatr Nephrol Date: 2018-07-07 Impact factor: 3.714
Authors: Audrey Uffing; Maria José Pérez-Sáez; Marilda Mazzali; Roberto C Manfro; Andrea Carla Bauer; Frederico de Sottomaior Drumond; Michelle M O'Shaughnessy; Xingxing S Cheng; Kuo-Kai Chin; Carlucci G Ventura; Fabiana Agena; Elias David-Neto; Juliana B Mansur; Gianna Mastroianni Kirsztajn; Helio Tedesco-Silva; Gilberto M V Neto; Carlos Arias-Cabrales; Anna Buxeda; Mathilde Bugnazet; Thomas Jouve; Paolo Malvezzi; Enver Akalin; Omar Alani; Nikhil Agrawal; Gaetano La Manna; Giorgia Comai; Claudia Bini; Saif A Muhsin; Miguel Carlos Riella; Silvia R Hokazono; Samira S Farouk; Meredith Haverly; Suraj Sarvode Mothi; Stefan P Berger; Paolo Cravedi; Leonardo V Riella Journal: Clin J Am Soc Nephrol Date: 2020-01-23 Impact factor: 8.237
Authors: Wen Y Ding; Ania Koziell; Hugh J McCarthy; Agnieszka Bierzynska; Murali K Bhagavatula; Jan A Dudley; Carol D Inward; Richard J Coward; Jane Tizard; Christopher Reid; Corinne Antignac; Olivia Boyer; Moin A Saleem Journal: J Am Soc Nephrol Date: 2014-02-07 Impact factor: 10.121