PRIMARY RECURRENT FOCAL SEGMENTAL GLOMERULOSCLEROSIS AFTER KIDNEY TRANSPLANTATION. CASE STUDY.

Abstract

Introduction. Primary recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation (KT) is a serious complication and a significant risk factor for graft loss. The incidence of FSGS worldwide varies from 1.4 to 21 cases per million population. FSGS develops due to damage to the visceral epithelial cells of the kidney glomerulus (podocytes) and is classified as a "podocytopathy." Objective. This study aims to demonstrate an early recurrence of FSGS with the development of nephrotic syndrome based on a clinical case and to evaluate the short-term feasibility of plasmapheresis sessions. Methods. The article describes a clinical case of early recurrence of FSGS with the development of nephrotic syndrome. The primary treatment for disease recurrence after kidney transplantation includes plasmapheresis sessions and the administration of rituximab. Results. Analysis of the clinical case revealed that kidney graft thrombosis was a consequence of a drop in blood pressure and a slowdown in blood flow at the anastomosis site during a plasmapheresis session, ultimately leading to graft loss and the patient's return to dialysis therapy. Conclusions. For subsequent planned kidney transplantation, the patient is at extremely high risk of disease recurrence according to the literature, making the procedure not feasible in the short term.