Incidence, risk factors, and outcomes of recurrent focal segmental glomerulosclerosis in pediatric kidney transplant recipients: A systematic review and meta‐analysis

医学 局灶节段性肾小球硬化 移植 肾移植 入射(几何) 肾脏疾病 风险因素 内科学 儿科 外科 泌尿科 肾小球肾炎 物理 光学
作者
Jiang Bai,Xinyu Yin,Jiaqi Li,Jiaqi Li,Y.-L. Niu,Zhenhua Li,Jing Li,Yun Zhou
出处
期刊:Clinical transplantation [Wiley]
卷期号:37 (11) 被引量:2
标识
DOI:10.1111/ctr.15119
摘要

Abstract Background Focal segmental glomerulosclerosis is the most prevalent acquired kidney disease leading to end‐stage renal disease in children and has a propensity for recurring in the transplanted kidney. The recurrence of FSGS after kidney transplantation in children varies greatly. In addition, the risk factors and outcomes of recurrence of FSGS remain controversial. This study evaluated the recurrence rate, risk factors, and prognosis of FSGS after kidney transplantation in order to provide advice and assistance in clinical decision‐making for pediatric kidney transplantation. Methods PubMed, Embase, Web of Science, CNKI, and other databases were searched from the establishment of the repository to March 2022. We extracted data on incidence, risk factors, and outcomes. Results The results showed that the recurrence rate of primary FSGS in children after renal transplantation was 48% (95% CI 36%–59%) and the recurrence rate of FSGS (all forms) was 35% (95% CI 17%–52%). The graft loss rate of primary FSGS in children after kidney transplantation was 29% (95% CI 17%–42%) and the graft loss rate of FSGS (all forms) was 29% (95% CI 4%–62%). 57% (95% CI 42%–73%) of pediatric patients with recurrent primary FSGS showed complete remission. Risk factor analyses showed that age of onset (SMD .69, 95% CI .20–1.19, p = .006) was related to the recurrence of primary FSGS, whereas the living related donor was not a risk factor for recurrent primary FSGS in pediatrics after kidney transplantation (OR 1.22, 95% CI .48–3.10, p = .674). Conclusions The recurrence rate and graft loss rate of FSGS in children after kidney transplantation were relatively high. Age at onset was associated with a risk for recurrent primary FSGS, whereas the living related donor was not a risk factor for recurrent FSGS in pediatric kidney recipients.
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