Abstract
Three patients with steroid-resistant idiopathic nephrotic syndrome were studied at onset and during recurrent nephrotic syndrome after renal transplantation. Renal biopsies at the onset of the nephrotic syndrome showed typical features of the idiopathic nephrotic syndrome; no or minimal focal glomerular abnormalities were present by light microscopy and glomerular-basement-oriented deposits were not demonstrated by immunofluorescent or electron microscopy. Progression to renal failure occurred in 2, 2, and 6 years. Recurrence of nephrotic syndrome was noted 1, 11/2, and 5 months after transplantation. Renal biopsies done 11/2, 5, and 7 months after transplantation when proteinuria was 12·8, 7·6, and 8·5 g. per 24 hours, respectively, showed minimal or no glomerular abnormalities by light microscopy. Immunofluorescent and electron microscopic studies revealed no evidence suggesting immunological injury. Subsequent kidney specimens after transplantation obtained from two of these patients with recurrent nephrotic syndrome showed focal segmental glomerulosclerosis limited primarily to the juxtamedullary glomeruli-a feature further suggesting recurrence of the original disease in the transplanted kidney. These observations suggest that the pathogenesis of the steroid-resistant idiopathic nephrotic syndrome may involve systemic circulating factors; this hypothesis would account for development of a recurrent nephrotic syndrome in the transplanted kidney.
| Original language | English |
|---|---|
| Pages (from-to) | 343-348 |
| Number of pages | 6 |
| Journal | The Lancet |
| Volume | 300 |
| Issue number | 7773 |
| DOIs | |
| State | Published - Aug 19 1972 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION. / Hoyer, JohnR; Raij, Leopoldo; Vernier, RobertL; Simmons, RichardL; Najarian, JohnS; Michael, AlfredF.
In: The Lancet, Vol. 300, No. 7773, 19.08.1972, p. 343-348.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION
AU - Hoyer, JohnR
AU - Raij, Leopoldo
AU - Vernier, RobertL
AU - Simmons, RichardL
AU - Najarian, JohnS
AU - Michael, AlfredF
PY - 1972/8/19
Y1 - 1972/8/19
N2 - Three patients with steroid-resistant idiopathic nephrotic syndrome were studied at onset and during recurrent nephrotic syndrome after renal transplantation. Renal biopsies at the onset of the nephrotic syndrome showed typical features of the idiopathic nephrotic syndrome; no or minimal focal glomerular abnormalities were present by light microscopy and glomerular-basement-oriented deposits were not demonstrated by immunofluorescent or electron microscopy. Progression to renal failure occurred in 2, 2, and 6 years. Recurrence of nephrotic syndrome was noted 1, 11/2, and 5 months after transplantation. Renal biopsies done 11/2, 5, and 7 months after transplantation when proteinuria was 12·8, 7·6, and 8·5 g. per 24 hours, respectively, showed minimal or no glomerular abnormalities by light microscopy. Immunofluorescent and electron microscopic studies revealed no evidence suggesting immunological injury. Subsequent kidney specimens after transplantation obtained from two of these patients with recurrent nephrotic syndrome showed focal segmental glomerulosclerosis limited primarily to the juxtamedullary glomeruli-a feature further suggesting recurrence of the original disease in the transplanted kidney. These observations suggest that the pathogenesis of the steroid-resistant idiopathic nephrotic syndrome may involve systemic circulating factors; this hypothesis would account for development of a recurrent nephrotic syndrome in the transplanted kidney.
AB - Three patients with steroid-resistant idiopathic nephrotic syndrome were studied at onset and during recurrent nephrotic syndrome after renal transplantation. Renal biopsies at the onset of the nephrotic syndrome showed typical features of the idiopathic nephrotic syndrome; no or minimal focal glomerular abnormalities were present by light microscopy and glomerular-basement-oriented deposits were not demonstrated by immunofluorescent or electron microscopy. Progression to renal failure occurred in 2, 2, and 6 years. Recurrence of nephrotic syndrome was noted 1, 11/2, and 5 months after transplantation. Renal biopsies done 11/2, 5, and 7 months after transplantation when proteinuria was 12·8, 7·6, and 8·5 g. per 24 hours, respectively, showed minimal or no glomerular abnormalities by light microscopy. Immunofluorescent and electron microscopic studies revealed no evidence suggesting immunological injury. Subsequent kidney specimens after transplantation obtained from two of these patients with recurrent nephrotic syndrome showed focal segmental glomerulosclerosis limited primarily to the juxtamedullary glomeruli-a feature further suggesting recurrence of the original disease in the transplanted kidney. These observations suggest that the pathogenesis of the steroid-resistant idiopathic nephrotic syndrome may involve systemic circulating factors; this hypothesis would account for development of a recurrent nephrotic syndrome in the transplanted kidney.
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UR - http://www.scopus.com/inward/citedby.url?scp=0015516194&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(72)91734-5
DO - 10.1016/S0140-6736(72)91734-5
M3 - Article
C2 - 4114718
AN - SCOPUS:0015516194
VL - 300
SP - 343
EP - 348
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 7773
ER -