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BioMed Research International
Volume 2016, Article ID 6832971, 7 pages
http://dx.doi.org/10.1155/2016/6832971
Review Article

Recurrence and Treatment after Renal Transplantation in Children with FSGS

1Department of Pediatrics, Seoul National University Hospital, Seoul 03080, Republic of Korea
2Research Coordination Center for Rare Diseases, Seoul National University Hospital, Seoul 03080, Republic of Korea
3Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea

Received 25 December 2015; Revised 14 March 2016; Accepted 4 April 2016

Academic Editor: Jun Oh

Copyright © 2016 Hee Gyung Kang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage renal disease and a common pathologic diagnosis of idiopathic nephrotic syndrome (NS), especially in steroid-resistant cases. FSGS is known to recur after kidney transplantation, frequently followed by graft loss. However, not all patients with FSGS suffer from recurrence after kidney transplantation, and genetic and secondary FSGS have a negligible risk of recurrence. Furthermore, many cases of recurrence achieve remission with the current management of recurrence (intensive plasmapheresis/immunosuppression, including rituximab), and other promising agents are being evaluated. Therefore, a pathologic diagnosis of FSGS itself should not cause postponement of allograft kidney transplantation. For patients with a high risk of recurrence who presented with classical symptoms of NS, that is, severe edema, proteinuria, and hypoalbuminemia, close monitoring of proteinuria is necessary, followed by immediate, intensive treatment for recurrence.