Understanding FSGS and Kidney Transplant Recurrence

Focal Segmental Glomerulosclerosis (FSGS) is a serious condition that attacks the kidneys’ filtering units. If FSGS is not detected early or if a patient doesn’t respond to the current treatment regimens, the consequences can be severe, potentially requiring hemodialysis or a kidney transplant.

A significant risk for patients with FSGS is recurrence after a kidney transplant, sometimes appearing as quickly as a few days post-surgery. The risk of FSGS returning in the transplanted kidney varies widely, from 30% to 50%.

Signs, Symptoms, and the Importance of Early Detection

FSGS can be difficult to detect, as the early stages often cause no noticeable symptoms. The importance of early detection cannot be overstated. You may only see some signs on your own (begin to feel sick, experience swelling, have foamy urine, and feel tired and rundown), while others may be found by your healthcare provider.

Signs and symptoms of FSGS, a severe form of kidney disease, include:

Swelling (edema): Often visible in body parts such as the legs, ankles, and around the eyes.

Weight gain: Due to extra fluid building up in your body.

Foamy urine (proteinuria): Caused by high protein levels in the urine.

High cholesterol levels in the blood.

Hypoalbuminemia: Low levels of protein in the blood

Please consult with your healthcare provider immediately if you exhibit any of these signs and symptoms for a proper diagnosis.

Understanding FSGS Recurrence After Kidney Transplant

The exact way that FSGS causes damage to the transplanted kidney is still not entirely clear, though evidence suggests it may be due to a substance present in the blood. Recurrence of FSGS after kidney transplantation remains a major risk factor for the loss of the new kidney.

Approximately 1,000 FSGS patients receive a kidney transplant each year. Recurrence is reported in:

Approximately 30–40% of adults within hours to weeks after transplantation.
Up to 50% of children post-transplant.

ADULTS⁴

FSGS recurrence occurs in one-third of kidney transplant patients within an average of 1.5 months.

Risk of kidney transplant failure increases almost five-fold after recurrent FSGS.

The median time from recurrence to graft loss is within 7 months.

PEDIATRIC⁵

Recurrence of non-genetic FSGS has a reported incidence of up to 50% in post-kidney transplant.

Almost one-half of patients lose their transplanted kidney within a period of 5 years after FSGS recurrence.

Recurrence of FSGS is associated with a reduction in graft survival. This is especially true for patients who have not responded to treatment.⁴

Testing for FSGS and Kidney Disease

If your healthcare provider suspects FSGS, they will review your medical history and may order a series of tests to confirm the diagnosis and determine the best treatment plan:

Urinalysis: A urine test to help find protein and blood in your urine.
Blood Tests: To find levels of protein and waste in your blood.
Glomerular Filtration Rate (GFR): A blood test to find out how well your kidneys are filtering waste from your body.
Kidney Biopsy: A tiny piece of your kidney is removed and looked at under a microscope for definitive diagnosis.
Genetic Testing: May be done to see if you were born with genes that caused your kidney disease.

Quick FAQs about FSGS

What is the main cause of FSGS? FSGS is classified as primary (idiopathic, cause unknown) or secondary (caused by a known factor like viral infections, drug toxicity, or other kidney issues). The primary type is the one most likely to recur after a transplant.

How is recurrent FSGS treated? Treatment may include immunosuppressive medications to suppress the immune response, as well as drugs to control blood pressure and reduce the amount of protein being lost in the urine. Specialized treatments like plasmapheresis or immunoadsorption (such as LIPOSORBER) are also used in some cases.

Can FSGS be cured? Currently, there is no definitive cure for FSGS. The primary goal of treatment is to reduce proteinuria, control symptoms, and prevent the progression to kidney failure. Early and aggressive treatment offers the best prognosis.

Ready to learn more about treatment options for FSGS? Explore how the LIPOSORBER system can assist in the therapeutic management of recurrent FSGS after a kidney transplant.

References:

Click here for LIPOSORBER Instructions for Use and safety information

Understanding FSGS and Kidney Transplant Recurrence

Signs, Symptoms, and the Importance of Early Detection