Plasmapheresis in the treatment of steroid-resistant focal segmental glomerulosclerosis in native kidneys

Advances in apheresis therapy for glomerular diseases

“…In addition, abnormal T cell function was also proposed as a pathogenic factor [27][28]. Savin's group reported that plasmapheresis could diminish proteinuria and stabilize renal function in a part of patients with steroid-resistant idiopathic FSGS, suggesting that FSGS have some different local or systemic factor(s) unrelated to glomerular permeability [9][10]28]. In addition, a recent prospective trial in 10 patients at high-risk for FSGS recurrence because of rapid progression to renal failure (n = 4) or prior transplant recurrence of FSGS (n = 6) underwent a course of 8 PE treatments in the perioperative period.…”

“…Circulating glomerular albumin permeability factor(s) were also detected in patients with native (primary) focal segmental glomerulosclerosis (FSGS) and recurrent FSGS after renal transplantation [4][5]. In such cases, plasma protein adsorption using Protein A sepharose cartridges [6][7] or anti-human immunoglobulin affinity immunoadsorption [7][8], plasma exchange (PE) [9][10], LDL apheresis [11] and/or LCAP [12] have been reported to be effective even for steroid-cyclosporin-A (CyA) resistant cases through removing the glomerular permeability factor(s) in some of these nephrotic patients. In this review, we overviewed the immunomodulation effects and clinical evidence of apheresis in various glomerular diseases, especially nephrotic syndrome and severe nephritic syndrome.…”

Renal Allograft Survival in Transplant Recipients with Focal Segmental Glomerulosclerosis

“…In addition, allograft failure from recurrent FSGS is significant with the relative risk for graft loss of 2.25 and the 5-year kidney survival rate of 34.2% for transplant recipients with recurrent FSGS (5). Attempts have been made to remove the 'FSGS factor' with plasmapheresis before renal transplantation or peri-operatively with variable success (6). Because of the substantial risk of renal allograft loss from recurrence of FSGS, it has been recommended that live donation be avoided (7).…”

A Brief Overview Of Childhood Nephrotic Syndrome: Review

“…Doğal böbrekte oluşan FSGS'de plazmaferez çok az sayıda çalışmada bildirilmiş-tir. [68][69][70] Bu durumun muhtemel nedeni, plazmaferezin invaziv bir girişim olmasıdır. Sonuçlar değişkendir.…”