Detwiler RK, Hogan SL, Falk RJ, Jennette C
Collapsing glomerulopathy (CG) in renal transplant patients:
recurrence and de novo occurrence
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1331 1996
Collapsing glomerulopathy has often been associated with HIV
nephropathy but is also well described as a subset of focal
gomerulosclerosis in HIV negative patients.
This abstract describes 10 transplant patients (all HIV negative) who
were biopsied because of nephrotic syndrome and/or declining renal
function and had CG in the allograft. Only 5 had biopsy proven
primary renal disease, of which 3 had CG. The mean creatinine at
biopsy was 3.6 mg/dl (range 0.8 - 10.7) and the average time post
transplant was 11 months (range 1 - 48). Seven patients were black, 2
white and 1 Hispanic.
Of the 10 patients, 8 are already on dialysis at a mean of 7 months
post biopsy. The authors observe that CG recurs and develops de
novo in transplants.
Comment: The clinical course, epidemiology and natural
history are somewhat skewed by the pre-biopsy selection of patients
with obvious advanced renal disease. The incidence and recurrence of
CG as well as its course in centers where "routine" post transplant
biopsies are performed regardless of graft function will help clarify
these issues. (Sri Narsipur, MD, SUNY-HSC at Syracuse, NY)
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Am Soc Nephrol
Proteinuria/Hematuria :
Focal, collapsing GN
Transplant :
Transplantation