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Regional secondary focal segmental glomerulosclerosis in a transplanted kidney : resolution with treatment of a segmental renal artery stenosis

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タイトル: Regional secondary focal segmental glomerulosclerosis in a transplanted kidney : resolution with treatment of a segmental renal artery stenosis
著者: Iwami, Daiki 著作を一覧する
Harada, Hiroshi 著作を一覧する
Usubuchi, Hiroaki 著作を一覧する
Hotta, Kiyohiko 著作を一覧する
Seki, Toshimori 著作を一覧する
Togashi, Masaki 著作を一覧する
Fukasawa, Yuichiro 著作を一覧する
キーワード: Kidney transplantation
Nephrotic syndrome
Renal artery stenosis
Secondary FSGS (focal segmental glomerulosclerosis)
発行日: 2012年 6月12日
出版者: BioMed Central
誌名: BMC nephrology
巻: 13
開始ページ: 38
出版社 DOI: 10.1186/1471-2369-13-38
抄録: Background: Conditions associated with high intraglomerular filtration pressure can cause secondary focal segmental glomerulosclerosis (FSGS). Unilateral renal artery stenosis (RAS) or its occlusion results in FSGS-like changes and the nephrotic syndrome in the contralateral kidney due to hyperfiltration. However, it has been rarely reported that stenosis of a renal arterial branch can result in FSGS-like changes in a different portion in the same kidney allograft. Case presentation: A 60-year-old male kidney recipient developed allograft dysfunction after angiotensin II receptor blockade for hypertension 4 months after transplantation. It was proven that one of two arterial branches of the graft was markedly stenotic. Graft dysfunction improved after percutaneous transluminal arterioplasty (PTA), however; the stenosis recurred and massive proteinuria developed 5 months later. Graft biopsy showed ischemic changes in the region fed by the stenotic artery branch and in contrast FSGS-like changes in the region fed by the other branch. His clinicopathological manifestation including massive proteinuria almost normalized after the repeat PTA. Conclusion: Here we report a case of secondary FSGS of a kidney allograft due to severe RAS of a branch of the same kidney, in which clinical and pathological improvement were confirmed after radiological intervention. When moderate to severe proteinuria appear, secondarily developed FSGS as well as primary (recurrent or de novo) FSGS should be taken into account in kidney transplant recipients.
資料タイプ: article
URI: http://hdl.handle.net/2115/64542
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 岩見 大基

 

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