PODOCYTURIA IN KIDNEY TRASPLANTATION: PRIMARY FOCAL SEGMENTAL GLOMERULOSCLEROSIS

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https://storage.unitedwebnetwork.com/files/1099/d9637a835bbbe9cebabd3af7c93049d3.pdf

Abstract Title

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CRISTIAN

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COSTALES - COLLAGUAZO

Co-author 1

Adriana Lituma collarbba@gmail.com University Hospital Fundación Favaloro Nephrology CABA

Co-author 2

Diego Scalise collarbba@gmail.com Clinical Hospital Nephrology CABA

Co-author 3

Federico Ochoa collarbba@gmail.com Faculty of Medicine, UBA Department of Physiological Sciences IFIBIO Houssay Conicet CABA

Co-author 4

Elsa Zotta collarbba@gmail.com Faculty of Pharmacy and Biochemistry, UBA, Faculty of Physiopathology CABA

Co-author 5

Rita Fortunato collarbba@gmail.com University Hospital Fundación Favaloro Nephrology CABA

Co-author 6

Pablo Raffaele collarbba@gmail.com University Hospital Fundación Favaloro Department of Nephrology CABA

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

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Co-author 15

Introduction

Focal segmental glomerulosclerosis (FSGS) is a common glomerular disorder that manifests clinically with nephrotic syndrome and >80% sloughing or loss of primary foot cells. After renal transplantation, recurrence of primary GSFS occurs in 30% to 50% of adults. The objective of our study is to analyze the presence of podocyturia in the evolution of proteinuric nephropathies and its characterization as an early marker of renal injury.

Methods

Descriptive observational study with prospective registration with continuous incorporation of patients. 10 patients are currently registered with sample analysis within the first month after kidney transplant. Indirect immunofluorescence techniques with primary antibody was made. Podocytes were identified by immunofluorescence using anti-synaptopodin as the primary antibody (1:100, Abcam, Cambridge, MA, USA) and IgG anti-rabbit Alexa Fluor® 488 (1:500, Abcam,Cambridge, MA, USA) as the secondary antibody. Samples were analyzed employing an epifluorescent microscope. Following our standardized technique, podocytes were counted in 10 randomly chosen 20× fields and the average of the counted podocytes in the microscopy fields was considered as the final count for each subject. Results were corrected based on the urinary creatinine concentration of the initial urinary volume.Immunolabeling was also performed on kidney tissue.

Results

The general characteristics of the study are described in Table 1. 70% of the transplant patients are male. The recipients have a median age of 30.6 years. Recurrence occurred in 40%, similar to the literature. The podocyturia/creatinuria index in the immediate post-transplant in patients who recurred was 19 POD cells/Cro gr, while in patients who did not recur it was 17.4 POD cells/Cro gr. The eGFR at the first month after transplant in patients who did not recur was 67.6 ml/min, as well as proteinuria was 0.43 gr/24 h. In the dynamics of podocyturia in the post-transplant, it is greater when the eGFR decreases. There is a correlation between podocyturia and proteinuria with a significant p r: -0.3. The labeling of synaptopidin in kidney tissue is presented in the control biospies of the patients.

Conclusions

The rate of recurrence and complete response to treatment that we found was similar to that reported in the literature. Podocyturia is related to the presence of proteinuria in the post-transplant evolution.

Synaptopdin labeling is useful in both urine and kidney tissue in patients with FSGS.

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