Abstract
Of children with idiopathic nephrotic syndrome, 10%-20% fail to respond to steroids or develop secondary steroid resistance (termed initial steroid sensitivity) and the majority progress to transplantation. Although 30%-50% of these patients suffer disease recurrence after transplantation, with poor long-term outcome, no reliable indicator of recurrence has yet been identified. Notably, the incidence of recurrence after transplantation appears reduced in patients with steroid-resistant nephrotic syndrome (SRNS) due to monogenic disorders. We reviewed 150 transplanted patients with SRNS to identify biomarkers that consistently predict outcome of SRNS after transplantation. In all, 25 children had genetic or familial SRNS and did not experience post-transplant recurrence. We reviewed phenotypic factors, including initial steroid sensitivity, donor type, age, ethnicity, time to ESRD, and time on dialysis, in the remaining 125 children. Of these patients, 57 (45.6%) developed post-transplant recurrence; 26 of 28 (92.9%) patients with initial steroid sensitivity recurred after transplantation, whereas only 26 of 86 (30.2%) patients resistant from the outset recurred (odds ratio, 30; 95% confidence interval, 6.62 to 135.86; P
Original language | English |
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Pages (from-to) | 1342-1348 |
Number of pages | 7 |
Journal | Journal of the American Society of Nephrology |
Volume | 25 |
Issue number | 6 |
DOIs | |
Publication status | Published - 7 Feb 2014 |
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Dive into the research topics of 'Initial Steroid Sensitivity in Children with Steroid-Resistant Nephrotic Syndrome Predicts Post-Transplant Recurrence'. Together they form a unique fingerprint.Profiles
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Professor Richard J M Coward
- Bristol Medical School (THS) - Professor of Renal Medicine
Person: Academic
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Dr Wen Ding
- Bristol Medical School (THS) - Consultant nephrologist and honorary Senior Lecturer, Honorary Senior Lecturer
Person: Honorary and Visiting Academic