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Clinical practice recommendations for recurrence of focal and segmental glomerulosclerosis/steroid-resistant nephrotic syndrome
LT. Weber, B. Tönshoff, R. Grenda, A. Bouts, R. Topaloglu, B. Gülhan, N. Printza, A. Awan, N. Battelino, R. Ehren, PF. Hoyer, G. Novljan, SD. Marks, J. Oh, A. Prytula, T. Seeman, C. Sweeney, L. Dello Strologo, L. Pape
Jazyk angličtina Země Dánsko
Typ dokumentu konsensus - konference, časopisecké články
Grantová podpora
German Society for Paediatric Nephrology (GPN) (5.000 €)
European Society for Paediatric Nephrology (ESPN) (2.000 €)
PubMed
33378587
DOI
10.1111/petr.13955
Knihovny.cz E-zdroje
- MeSH
- dítě MeSH
- fokálně segmentální glomeruloskleróza prevence a kontrola terapie MeSH
- glukokortikoidy terapeutické užití MeSH
- léková rezistence MeSH
- lidé MeSH
- nefrotický syndrom prevence a kontrola terapie MeSH
- pooperační komplikace prevence a kontrola terapie MeSH
- recidiva MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- transplantace ledvin * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
Recurrence of primary disease is one of the major risks for allograft loss after pediatric RTx. The risk of recurrence of FSGS/SRNS after pediatric RTx in particular can be up to 86% in idiopathic cases. There is a need for consensus recommendations on its prevention and treatment. The CERTAIN study group has therefore performed a thorough literature search based on the PICO model of clinical questions to formulate educated statements to guide the clinician in the process of decision-making. A set of educated statements on prevention and treatment of FSGS/SRNS after pediatric RTx has been generated after careful evaluation of available evidence and thorough panel discussion. We do not recommend routine nephrectomy prior to transplantation; neither do we recommend abstaining from living donation. Special attendance needs to be given to those patients who had already experienced graft loss due to FSGS/SRNS recurrence. Early PE or IA with or without high-dose CsA and/or rituximab seems to be most promising to induce remission. The educated statements presented here acknowledge that FSGS/SRNS recurrence after pediatric RTx remains a major concern and is associated with shorter graft survival or even graft loss. The value of any recommendation needs to take into account that evidence is based on cohorts that differ in ethnicity, pre-transplant history, immunosuppressive regimen, definition of recurrence (eg, clinical and/or histological diagnosis) and treatment modalities of recurrence.
Department of Nephrology and Transplantation Children's Health Ireland Dublin Ireland
Department of Pediatric Nephrology School of Medicine Hacettepe University Ankara Turkey
Department of Pediatrics 2 University Hospital of Essen University Duisburg Essen Essen Germany
Department of Pediatrics 2nd Medical Faculty Charles University Prague Prague Czech Republic
Department of Pediatrics University Children's Hospital Heidelberg Heidelberg Germany
Pediatric Nephrology and Rheumatology Department Ghent University Hospital Ghent Belgium
Pediatric Renal Transplant Unit Bambino Gesù Children's Research Hospital IRCCS Rome Italy
Citace poskytuje Crossref.org
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- $a Recurrence of primary disease is one of the major risks for allograft loss after pediatric RTx. The risk of recurrence of FSGS/SRNS after pediatric RTx in particular can be up to 86% in idiopathic cases. There is a need for consensus recommendations on its prevention and treatment. The CERTAIN study group has therefore performed a thorough literature search based on the PICO model of clinical questions to formulate educated statements to guide the clinician in the process of decision-making. A set of educated statements on prevention and treatment of FSGS/SRNS after pediatric RTx has been generated after careful evaluation of available evidence and thorough panel discussion. We do not recommend routine nephrectomy prior to transplantation; neither do we recommend abstaining from living donation. Special attendance needs to be given to those patients who had already experienced graft loss due to FSGS/SRNS recurrence. Early PE or IA with or without high-dose CsA and/or rituximab seems to be most promising to induce remission. The educated statements presented here acknowledge that FSGS/SRNS recurrence after pediatric RTx remains a major concern and is associated with shorter graft survival or even graft loss. The value of any recommendation needs to take into account that evidence is based on cohorts that differ in ethnicity, pre-transplant history, immunosuppressive regimen, definition of recurrence (eg, clinical and/or histological diagnosis) and treatment modalities of recurrence.
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