RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION

JohnR Hoyer, Leopoldo Raij, RobertL Vernier, RichardL Simmons, JohnS Najarian, AlfredF Michael

Research output: Contribution to journalArticle

220 Citations (Scopus)

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 languageEnglish
Pages (from-to)343-348
Number of pages6
JournalThe Lancet
Volume300
Issue number7773
DOIs
StatePublished - Aug 19 1972
Externally publishedYes

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Nephrotic Syndrome
Kidney Transplantation
Kidney
Recurrence
Transplantation
Microscopy
Biopsy
Light
Focal Segmental Glomerulosclerosis
Proteinuria
Renal Insufficiency
Electron Microscopy
Congenital Nephrosis
Electrons
Wounds and Injuries
Nephrotic syndrome, idiopathic, steroid-resistant

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hoyer, J., Raij, L., Vernier, R., Simmons, R., Najarian, J., & Michael, A. (1972). RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION. The Lancet, 300(7773), 343-348. https://doi.org/10.1016/S0140-6736(72)91734-5

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 journalArticle

Hoyer, J, Raij, L, Vernier, R, Simmons, R, Najarian, J & Michael, A 1972, 'RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION', The Lancet, vol. 300, no. 7773, pp. 343-348. https://doi.org/10.1016/S0140-6736(72)91734-5
Hoyer J, Raij L, Vernier R, Simmons R, Najarian J, Michael A. RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION. The Lancet. 1972 Aug 19;300(7773):343-348. https://doi.org/10.1016/S0140-6736(72)91734-5
Hoyer, JohnR ; Raij, Leopoldo ; Vernier, RobertL ; Simmons, RichardL ; Najarian, JohnS ; Michael, AlfredF. / RECURRENCE OF IDIOPATHIC NEPHROTIC SYNDROME AFTER RENAL TRANSPLANTATION. In: The Lancet. 1972 ; Vol. 300, No. 7773. pp. 343-348.
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