Preemptive therapeutic plasma exchange (TPE) and rituximab treatment may lower the risk of recurrence of focal segmental glomerulosclerosis (FSGS) in kidney transplant recipients, according to study findings presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings.
Venkata Kishore Mukku, MD, of The University of Texas Medical Branch in Galveston, and colleagues studied 18 kidney transplant recipients (KTRs) in whom FSGS was the primary cause of end-stage kidney disease. Of these, 8 underwent preemptive TPE/rituximab treatment (group 1) and 10 did not (group 2). Patients in group 1 and 2 had a median age of 33 and 36 years, respectively, at the time of transplantation. The median follow-up duration was 2 years for group 1 and 3 years for group 2. At the end of follow-up, the median creatinine level was 1.3 mg/dL for group 1 and 1.7 mg/dL for group 2, according to the investigators. The urine protein-creatinine ratio was 0.2 for group 1 and 0.6 for group 2.
Three patients in group 2 experienced FSGS recurrence compared with none in group 1, the investigators reported in a poster presentation. One patient in group 2 experienced allograft loss due to FSGS recurrence.
Dr Mukku and colleagues cited research showing that FSGS recurrence in renal transplant recipients leads to allograft loss in nearly 60% of cases and is associated with poor outcomes.
Mukku VK, Gamilla-Crudo A, Hussain S, Mujtaba MA. Overview of recurrence of focal segmental glomerulosclerosis in renal transplant patients and effectiveness of pre-emptive plasma exchange and rituximab in preventing recurrence. Presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings, April 6-10. Poster 370.