Recurrent Glomerulonephritis After Transplant — Management Pathway
Follow a structured pathway when recurrent glomerulonephritis is suspected in a kidney allograft: recognise the early signals, decide when to biopsy, and start treatment such as plasmapheresis for recurrent FSGS quickly enough to matter.
When to use it
Use when a transplant recipient with a glomerulonephritis history develops new or rising proteinuria or an unexplained creatinine rise. The pathway prioritises early recognition and biopsy over watchful waiting, because early treatment of recurrent FSGS improves remission.
Category
Transplantation. Related searches: recurrent fsgs treatment, gn recurrence pathway, plasmapheresis fsgs transplant, post-transplant proteinuria.
References
Cosio FG, Cattran DC. Recent advances in our understanding of recurrent primary glomerulonephritis after kidney transplantation. Kidney Int. 2017;91(2):304-314
KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients. Am J Transplant. 2009;9(Suppl 3):S1-S157
Common clinical questions
Proteinuria is rising in a transplant recipient who had FSGS — is the disease recurring? New or rising proteinuria after an FSGS transplant should trigger an urgent recurrence work-up. Check a urine protein-to-creatinine ratio and biopsy early, because recurrent FSGS can show only foot-process effacement on electron microscopy with normal light microscopy. Treat established recurrence with plasmapheresis, often combined with rituximab; the earlier plasmapheresis starts, the better the remission rate.
About NephroMind
This calculator is part of NephroMind, a free clinical decision-aid platform from the Arab Society of Nephrology and Renal Transplantation (ASNRT) — over 125 bedside nephrology calculators plus a renal drug-dosing database, coded by a practicing transplant nephrologist.