Recurrence of focal segmental glomerular sclerosis (FSGS) after renal transplantation

Focal segmental glomerular sclerosis (FSGS) is a pathological term to indicate glomerular lesions associated with distinctive clinical features. In most cases, FSGS is primary in nature and is called idiopathic. Idiopathic FSGS is often associated with a nephrotic syndrome (NS) and may affect both children and adults. While the prognosis of FSGS is relatively good for patients with subnephrotic proteinuria, most patients with persisting proteinuria progress to end stage renal disease (ESRD) in spite of glucocorticoid or immunosuppressive treatment. For most of these patients, renal transplantation should be considered as the treatment of choice. However, in FSGS, the success of renal transplantation may be impaired by the frequent risk of recurrence of the disease on the allograft and by the poor graft survival rate in patients with recurrence. This paper will focus on the risk factors for recurrence, the possible pathogenesis of recurrence and the clinical results of renal transplantation in patients with FSGS.