Podocyte foot process effacement in postreperfusion allograft biopsies correlates with early recurrence of proteinuria in focal segmental glomerulosclerosis.

Jei Wen Chang, Victoriano Pardo, Junichiro Sageshima, Linda Chen, Hsin Lin Tsai, Jochen Reiser, Changli Wei, Gaetano Ciancio, George W. Burke, Alessia Fornoni

Research output: Contribution to journalArticle

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Abstract

Focal segmental glomerulosclerosis (FSGS) is a relatively prevalent glomerular disorder that often progresses to end-stage renal disease. Thirty to 80% of kidney transplant (KT) recipients with FSGS will experience recurrence characterized by proteinuria and podocyte damage. We hypothesized that the degree of podocyte foot process (FP) effacement in postreperfusion transplant biopsies can be used to predict the development of clinical recurrence of FSGS. Nineteen pairs of pre- and postreperfusion biopsy specimens were studied. We evaluated the degree of FP effacement in postreperfusion KT biopsies by counting the number of widened FP per capillary loop. Early recurrence of FSGS was defined as development of nephrotic range proteinuria between days 3 and 30 posttransplant. Early recurrence occurred in 7 of 19 grafts (36.8%) at a mean of 4.29±1.89 days. The mean score of FP effacement in postreperfusion allograft biopsies was 0.72±0.31 and 1.35±0.63 in the nonrecurrent and recurrent group, respectively (P=0.039). There was an association between FP effacement and proteinuria (P = 0.04). The FP effacement score predicts early recurrence with a sensitivity of 71.4% and specificity of 91.7%. FP effacement can be observed within minutes after reperfusion in renal transplantation of recipients with FSGS that will ultimately develop recurrent FSGS. This suggests a key role for the podocyte injury in the pathogenesis of recurrent FSGS and further supports the presence of circulating factors causing FP effacement. The FP effacement score in the postreperfusion KT biopsy may become a useful predictive test if validated in larger studies.

Original languageEnglish (US)
Pages (from-to)1238-1244
Number of pages7
JournalUnknown Journal
Volume93
Issue number12
StatePublished - Jan 1 2012
Externally publishedYes

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Focal Segmental Glomerulosclerosis
Podocytes
Proteinuria
Allografts
Biopsy
Recurrence
Transplants
Kidney
Kidney Transplantation
Chronic Kidney Failure
Reperfusion
Sensitivity and Specificity
Wounds and Injuries

ASJC Scopus subject areas

  • Transplantation

Cite this

Podocyte foot process effacement in postreperfusion allograft biopsies correlates with early recurrence of proteinuria in focal segmental glomerulosclerosis. / Chang, Jei Wen; Pardo, Victoriano; Sageshima, Junichiro; Chen, Linda; Tsai, Hsin Lin; Reiser, Jochen; Wei, Changli; Ciancio, Gaetano; Burke, George W.; Fornoni, Alessia.

In: Unknown Journal, Vol. 93, No. 12, 01.01.2012, p. 1238-1244.

Research output: Contribution to journalArticle

Chang, JW, Pardo, V, Sageshima, J, Chen, L, Tsai, HL, Reiser, J, Wei, C, Ciancio, G, Burke, GW & Fornoni, A 2012, 'Podocyte foot process effacement in postreperfusion allograft biopsies correlates with early recurrence of proteinuria in focal segmental glomerulosclerosis.', Unknown Journal, vol. 93, no. 12, pp. 1238-1244.
Chang, Jei Wen ; Pardo, Victoriano ; Sageshima, Junichiro ; Chen, Linda ; Tsai, Hsin Lin ; Reiser, Jochen ; Wei, Changli ; Ciancio, Gaetano ; Burke, George W. ; Fornoni, Alessia. / Podocyte foot process effacement in postreperfusion allograft biopsies correlates with early recurrence of proteinuria in focal segmental glomerulosclerosis. In: Unknown Journal. 2012 ; Vol. 93, No. 12. pp. 1238-1244.
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AU - Sageshima, Junichiro

AU - Chen, Linda

AU - Tsai, Hsin Lin

AU - Reiser, Jochen

AU - Wei, Changli

AU - Ciancio, Gaetano

AU - Burke, George W.

AU - Fornoni, Alessia

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N2 - Focal segmental glomerulosclerosis (FSGS) is a relatively prevalent glomerular disorder that often progresses to end-stage renal disease. Thirty to 80% of kidney transplant (KT) recipients with FSGS will experience recurrence characterized by proteinuria and podocyte damage. We hypothesized that the degree of podocyte foot process (FP) effacement in postreperfusion transplant biopsies can be used to predict the development of clinical recurrence of FSGS. Nineteen pairs of pre- and postreperfusion biopsy specimens were studied. We evaluated the degree of FP effacement in postreperfusion KT biopsies by counting the number of widened FP per capillary loop. Early recurrence of FSGS was defined as development of nephrotic range proteinuria between days 3 and 30 posttransplant. Early recurrence occurred in 7 of 19 grafts (36.8%) at a mean of 4.29±1.89 days. The mean score of FP effacement in postreperfusion allograft biopsies was 0.72±0.31 and 1.35±0.63 in the nonrecurrent and recurrent group, respectively (P=0.039). There was an association between FP effacement and proteinuria (P = 0.04). The FP effacement score predicts early recurrence with a sensitivity of 71.4% and specificity of 91.7%. FP effacement can be observed within minutes after reperfusion in renal transplantation of recipients with FSGS that will ultimately develop recurrent FSGS. This suggests a key role for the podocyte injury in the pathogenesis of recurrent FSGS and further supports the presence of circulating factors causing FP effacement. The FP effacement score in the postreperfusion KT biopsy may become a useful predictive test if validated in larger studies.

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