To investigate the risk factors of focal segmental glomerulosclerosis (FSGS) recurrence in renal transplantation and its therapy.

The clinical data of 16 patients with FSGS underwent transplantation between January 2008 to April 2017 in Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, were retrospectively analyzed. The rate of early recurrent FSGS after transplantation was observed in 16 patients. The effect of high-dose cyclosporine combined with plasma exchange was also observed. Including 6 cases in group with recurrence (R group) and 10 cases in group without recurrence (NR group). The age at onset of primary disease, the patients′ age and donors′ age at transplantation were compared by t Test; the progressed to end stage renal disease (ESRD) time, HLA mismatching numbers and duration of dialysis were compared by Mann-Whitney Test; the sex of recipients, donor type, the sex of donors, whether use the immunological induction and whether use the rituximab were compared by Fisher′s Exact Test. P<0.05 was considered statistically significant.

The progressed to ESRD time of R group and NR group was 1.0 year (0.3-5.9 years) and 9.2 years (0.5-14.0 years), it′s statistically significant (U=7.00, P<0.05). The sex of recipients, the age at onset of disease, duration of dialysis, donor type, the age of the patients and the age of donors at transplantation, HLA mismatching numbers, whether use immunological induction, whether use the rituximabthe, age of donors and sex of donors, no differences were observed between two groups (P all>0.05). Of the 6 patients in R group, 3 achieved complete remission, 2 achieved partial remission in a short term, 1 achieved partial remission after the use of high-dose of cyclosporine combined with plasma exchange.

This study confirms that early using of high-dose of cyclosporine combined with plasma exchange can quickly, effectively and continuously relieve the degree and progress of recurrent FSGS in transplanted kidney. It also indicates that a rapid progression to ESRD is a reliable risk factor for the early recurrence of FSGS after renal transplantation.