An update on the treatment options for focal segmental glomerulosclerosis

Expert Opinion on Pharmacotherapy

Volumn 10, Issue 4, 2009, Pages 615-628

  Meyrier, Alain ^a  

^a UNIVERSITÉ PARIS DESCARTES   (France)

Author keywords

Alkylating agents; Azathioprine; Calcineurin inhibitors; Corticosteroid therapy; Cyclosporine A; Focal segmental glomerulonephritis; Genetics of FSGS; Idiopathic nephrotic syndrome; Immunoabsorption; Immunophillin modulators; Immunosuppression; Mycophenolate mofetil; Plasmapheresis; Podocyte; Relapse of primary glomerulopathy; Renal transplantation; Rituximab; Sirolimus; Tacrolimus

Indexed keywords

ALKYLATING AGENT; ANGIOTENSIN ANTAGONIST; AZATHIOPRINE; CHLORAMBUCIL; CHLORMETHINE; CORTICOSTEROID; CORTICOTROPIN; CYCLOPHOSPHAMIDE; CYCLOSPORIN; CYCLOSPORIN A; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; GLUCOCORTICOID; METHYLPREDNISOLONE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PREDNISOLONE; PREDNISONE; RAPAMYCIN; RITUXIMAB; STEROID; TACROLIMUS; IMMUNOSUPPRESSIVE AGENT;

ADD ON THERAPY; ALPORT SYNDROME; ANEMIA; CHILDHOOD DISEASE; CLINICAL TRIAL; DISEASE CLASSIFICATION; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG MECHANISM; DRUG SAFETY; DRUG SUBSTITUTION; DRUG WITHDRAWAL; FOCAL GLOMERULOSCLEROSIS; GLOMERULOPATHY; HISTOLOGY; HUMAN; HYPERTENSION; IDIOPATHIC DISEASE; LOW DRUG DOSE; MEMBRANOUS GLOMERULONEPHRITIS; NEPHROTIC SYNDROME; NEPHROTOXICITY; NONHUMAN; PALLIATIVE THERAPY; PATHOPHYSIOLOGY; PROTEINURIA; RECOMMENDED DRUG DOSE; REVIEW; SEIZURE; SEPSIS; UNSPECIFIED SIDE EFFECT; DRUG COMBINATION; DRUG EFFECT; NEPHROLOGY; PATHOLOGY; PODOCYTE;

CYCLOSPORINE; DRUG THERAPY, COMBINATION; GLOMERULOSCLEROSIS, FOCAL SEGMENTAL; GLUCOCORTICOIDS; HUMANS; IMMUNOSUPPRESSIVE AGENTS; NEPHROLOGY; PODOCYTES;

EID: 65649089840     PISSN: 14656566     EISSN: None     Source Type: Journal    
DOI: 10.1517/14656560902754029     Document Type: Review

References (101)

1. Meyrier A, Niaudet P. Minimal changes and focal-segmental glomerulosclerosis. Third edition. In: Davison AM, Cameron JS, Grünfeld JP, et al, editors, Oxford Textbook of Clinical Nephrology. Vol.1. Oxford: Oxford University Press, 2005. p. 439-469
2. Meyrier A. Mechanisms of disease: focal segmental glomerulosclerosis. Nat Clin Pract Nephrol 2005;1:44-54 •• Recommended, but slightly outdated in 2009.
3. Braden GL, Mulhern JG, O'Shea MH, et al. Changing incidence of glomerular diseases in adults. Am J Kidney Dis 2000;35:878-883 (Pubitemid 30238200)
4. Filler G, Young E, Geier P, et al. Is there really an increase in non-minimal change nephrotic syndrome in children? Am J Kidney Dis 2003;42:1107-13 • The answer is yes, but the reason unknown.
5. Korbet SM. Clinical picture and outcome of primary focal segmental glomerulosclerosis. Nephrol Dial Transplant 1999;14(Suppl 3):68-73
6. Crook ED, Habeeb D, Gowdy O, et al. Effects of steroids on focal segmental glomerulosclerosis in a predominantly African-American population. Am J Med Sci 2005;330:19-24 (Pubitemid 41003682)
7. Meyrier A. Treatment of focal segmental glomerulosclerosis. Expert Opin Pharmacother 2005;6:1539-1549 (Pubitemid 41135804)
8. Barisoni L, Schnaper HW, Kopp JB. A proposed taxonomy for the podocytopathies: a reassessment of the primary nephrotic diseases. Clin J Am Soc Nephrol 2007;2:529-542 •• Interesting concept of structural versus functional variants of idiopathic nephrotic syndrome.
9. Wiggins RC. The spectrum of podocytopathies: a unifying view of glomerular diseases. Kidney Int 2007;71:1205-1214 •• Extends the previous concept to 90% of glomerulopathies. (Pubitemid 46884251)
10. D'Agati VD, Fogo AB, Bruijn JA, Jennette JC. Pathologic classification of focal segmental glomerulosclerosis: a working proposal. Am J Kidney Dis 2004;43:368-382 •• A classic. Does not meet universal agreement. (Pubitemid 38146337)
11. Korbet SM. Treatment of primary focal segmental glomerulosclerosis. J Am Soc Nephrol 2002;62:2301-2310 •• One of the best in depth overviews regarding treatment as of 2002.
12. Chun MJ, Korbet SM, Schwartz MM, Lewis EJ. Focal segmental glomerulosclerosis in nephrotic adults: presentation, prognosis, and response to therapy of the histologic variants. J Am Soc Nephrol 2004;8:2169-77 •• Excellent review following and completing the previous one [11]. (Pubitemid 39031355)
13. Stokes BM, Markowitz GS, Lin J, et al. Glomerular tip lesion: a distinct entity within the minimal change disease/focal segmental glomerulosclerosis spectrum. Kidney Int 2004;65:1690-1702 •• Very good, exhaustive review. May cast doubt on the individuality of the glomerular tip lesion amongst variants of FSGS. (Pubitemid 38591017)
14. Albaqumi M, Soos TJ, Barisoni L, Nelson PJ. Collapsing glomerulopathy. J Am Soc Nephrol 2006;10:2854-63 •• Review of the worst variant of FSGS according to the 'Columbia classification' [10].
15. Schwartz MM, Evans J, Bain R, Korbet SM. Focal segmental glomerulosclerosis: prognostic implications of the cellular lesion. J Am Soc Nephrol 1999;10:1900-7 •• Still valid regarding the prognosis of 'cell-FSGS', especially in blacks.
16. Bariety J, Nochy D, Mandet C, et al. Podocytes undergo phenotypic changes and express macrophagic-associated markers in idiopathic collapsing glomerulopathy. Kidney Int 1998;53:918-28 •• This paper is essential to understanding the 'dysregulation' of the podocyte phenotype in 'cell-FSGS'.
17. Barisoni L, Kriz W, Mundel P, D'Agati V. The dysregulated podocyte phenotype; a novel concept in the pathogenesis of collapsing idiopathic focal segmental glomerulosclerosis and HIV-associated nephropathy. J Am Soc Nephrol 1999;10:51-61 •• This paper is essential to understanding the 'dysregulation' of the podocyte phenotype in 'cell-FSGS'.
18. Bariety J, Bruneval P, Hill GS, et al. Posttransplantation relapse of FSGS is characterized by glomerular epithelial cell transdifferentiation. J Am Soc Nephrol 2001;12:261-74 •• This paper is essential to understanding the 'dysregulation' of the podocyte phenotype in 'cell-FSGS'.
19. Winn MP. Approach to the evaluation of heritable diseases and update on familial focal segmental glomerulosclerosis. Nephrol Dial Transplant 2003;18(Suppl 6):14-20 (Pubitemid 37098588)
20. Niaudet P. Podocin and nephrotic syndrome: implications for the clinician. J Am Soc Nephrol 2004;15:832-834 (Pubitemid 38294817)
21. Ghiggeri GM, Carraro M, Vicenti F. Recurrent focal glomerulosclerosis in the era of genetics of podocyte proteins: theory and therapy. Nephrol Dial Transpl 2004;19:1036-1040 (Pubitemid 38628117)
22. Daskalakis N, Winn MP. Focal and segmental glomerulosclerosis. Cell Mol Life Sci 2006;63:2506-2511 (Pubitemid 44722381)
23. Löwik MM, Hol FA, Steenbergen EJ, et al. Mitochondrial tRNA Leu(uur) mutation in a patient with steroid-resistant nephrotic syndrome and focal segmental glomerulosclerosis. Nephrol Dial Transplant 2005;20:336-341 (Pubitemid 40276889)
24. Voskarides K, Damianou L, Neocleous V, et al. COL4A3/COL4A4 mutations producing focal segmental glomerulosclerosis and renal failure in thin basement membrane nephropathy. J Am Soc Nephrol 2007;18:3004-3016 •• A new entity. (Pubitemid 350058408)
25. Kopp JB, Smith MW, Nelson GW, et al. MYH9 is a major-effect risk gene for focal segmental glomerulosclerosis. Nat Genet 2008;40:1175-1184 •• Important contribution that sheds light on the propensity of black Africans to develop FSGS.
26. Winn MP. Young Investigator Award: TRP'ing into a new era for glomerular diseases. J Am Soc Nephr 2008;19:1071-1075 •• Remarkable, obligatory reading.
27. Waldman M, Kopp JB. Parvovirus B19 and the kidney. Clin J Am Soc Nephrol 2007;2:S47-56
28. Shalhoub RJ. Pathogenesis of lipoid nephrosis: a disorder of T cell function. Lancet 1974;ii:556-559 • A classic, but later misinterpreted regarding the pathophysiology of FSGS.
29. Brenchley PEC. Vascular permeability factors in steroid-sensitive nephrotic syndrome and focal segmental glomerulosclerosis. Nephrol Dial Transpl 2003;18(Suppl 6):21-25 (Pubitemid 37098589)
30. Savin VJ, Artero M, Sharma M, et al. Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental sclerosis. N Engl J Med 1996;334:878-882 (Pubitemid 26107345)
31. Kemper MJ, Wolf G, Müller-wiefel DE. Transmission of glomerular permeability factor from a mother to her child. N Engl J Med 2001;344:386-387 (Pubitemid 32107655)
32. Savin VJ, McCarthy ET, Sharma R, et al. Galactose binds to focal segmental glomerulosclerosis permeability factor and inhibits its activity. Transl Res 2008;151:288-292 •• A new hope? Future will tell.
33. Ruf RG, Lichtenberger A, Karle SM, et al. Patients with mutations in NPHS2 (podocin) do not respond to standard steroid treatment of nephrotic syndrome. J Am Soc Nephrol 2004;15:722-732 (Pubitemid 38294803)
34. Wilmer WA, Rovin BH, Hebert CJ, et al. Management of glomerular proteinuria: a commentary. J Am Soc Nephrol 2003;14:3217-3232 •• Important paper, focussing on evidence-based data. (Pubitemid 37509297)
35. Barton M. Medscape. Reversal of proteinuric renal disease and the emerging role of endothelin. Nat Clin Pract Nephrol 2008;4:490-501 •• A step forward in symptomatic regimen.
36. Berg AL, Arnadottir M. ACTH-induced improvement in the nephrotic syndrome in patients with a variety of diagnoses. Nephrol Dial Transplant 2004;19:1305-1307 •• Interesting contribution on a new supportive regimen of FSGS and other forms of idiopathic nephrotic syndrome. (Pubitemid 38628157)
37. Troyanov S, Wall CA, Miller JA, et al. Toronto Glomerulonephritis Registry Group. Focal and segmental glomerulosclerosis: definition and relevance of a partial remission. J Am Soc Nephrol 2005;16:1061-1068 •• A convincing plea for reducing proteinuria, even by partial remission.
38. Buttgereit F, Straub RH, Wehling M, Burmester GR. Glucocorticoids in the treatment of rheumatic diseases. An update on the mechanisms of action. Arthritis Rheum 2004;50:3408-3417
39. Braun N, Schmutzler F, Lange C, et al. Immunosuppressive treatment for focal segmental glomerulosclerosis in adults. Cochrane Database Syst Rev 2008;3. Article 16:CD003233. DOI:10.1002/14651858 •• A lucid acknowledgement on the lack of large scale, randomized studies.
40. Nakayama M, Katafuchi R, Yanase T, et al. Steroid responsiveness and frequency of relapse in adult-onset minimal change nephrotic syndrome. Am J Kidney Dis 2002;39:503-512 •• Illustrates what a wrong definition of steroid resistance can be in adults. (Pubitemid 34194626)
41. Silverstein DM, Craver R. Presenting features and short-term outcome according to pathologic variant in childhood primary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 2007;2:700-707
42. Tune BM, Mendoza SA. Treatment of the idiopathic nephrotic syndrome: regimens and outcomes in children and adults. J Am Soc Nephrol 1997;8:824-832 (Pubitemid 27493599)
43. Waldo FB, Benfield MR, Kohaut EC. Therapy of focal and segmental glomerulosclerosis with methylprednisolone, cyclosporine A, and prednisone. Pediatr Nephrol 1998;12:397-400 (Pubitemid 28318950)
44. Ehrich JH, Pape L, Schiffer M. Corticosteroid-resistant nephrotic syndrome with focal and segmental glomerulosclerosis : an update of treatment options for children. Paediatr Drugs 2008;10:9-22 •• Important contribution to the treatment of childhood FSGS.
45. Philibert D, Cattran D. Remission of proteinuria in primary glomerulonephritis: we know the goal but do we know the price? Nat Clin Pract Nephrol 2008;4:550-559 •• The voice of clinical wisdom.
46. Arbeitsgemeinschaft für pädiatrische Nephrologie; Oemar BS, Brodehl J. Cyclophosphamide treatment of steroid dependent nephrotic syndrome: comparison of eight week with 12 week course. Arch Dis Child 1987;62:1102-1106
47. Heering P, Braun N, Mullejans R, et al. Cyclosporine A and chlorambucil in the treatment of idiopathic focal glomerulosclerosis. Am J Kidney Dis 2004;43:10-18 (Pubitemid 38049430)
48. Tarshish P, Tobin JN, Bernstein J, Edelmann CM Jr. Cyclophosphamide does not benefit patients with focal segmental glomerulosclerosis. A report of the International Study of Kidney Disease in Children. Pediatr Nephrol 1996;10:590-593
49. Meyrier A. Treatment of idiopathic nephrosis by immunophillin modulation. Nephrol Dial Transplant 2003;18(Suppl 6):79-86 (Pubitemid 37098600)
50. Rao A. Signaling to gene expression: calcium, calcineurin and NFAT. Nat Immunol 2009;10:3-5
51. Kaminuma O. Selective inhibitors of nuclear factor of activated T cells: potential therapeutic drugs for the treatment of immunological and inflammatory diseases. Inflamm Allergy Drug Targets 2008;7:35-40 (Pubitemid 351663644)
52. Cattran DC, Appel GB, Hebert LA, et al. A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis. Kidney Int 1999;56:2220-6 •• One of the rare randomised trials; illustrates a 'protective' effect of cyclosporine on renal function in FSGS.
53. Wilkinson AH, Cohen DJ. Renal failure in the recipients of nonrenal solid organ transplants. J Am Soc Nephrol 1999;10:1136-1144 (Pubitemid 29203102)
54. Meyrier A. Antiproteinuric and immunologic effects of cyclosporin A in the treatment of glomerular diseases. Nephrol Dial Transplant 1992;7(Suppl 1):80-84 (Pubitemid 23016772)
55. Meyrier A. Treatment of idiopathic nephrotic syndrome with cyclosporine A. J Nephrol 1997;10:14-24 (Pubitemid 27132476)
56. Chen D, Jefferson B, Harvey SJ, et al. Cyclosporine A slows the progressive renal disease of Alport syndrome (X-linked hereditary nephritis): results from a canine model. J Am Soc Nephrol 2003;14:690-698 •• Fascinating findings on the non-immunologic action of CsA. (Pubitemid 36246013)
57. Charbit M, Gubler MC, Dechaux M, et al. Cyclosporin therapy in patients with Alport syndrome. Pediatr Nephrol 2007;22:57-63 (Pubitemid 46138361)
58. Ambalavanan S, Fauvel JP, Sibley RK, Myers BD. Mechanism of the antiproteinuric effect of cyclosporine in membranous nephropathy. J Am Soc Nephrol 1996;7:290-298 •• Fascinating findings on the non-immunologic action of CsA. (Pubitemid 126832671)
59. Faul C, Donnelly FC, Merscher-Gomez S, et al. The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporin A. Nat Med 2008;14:931-938 •• A remarkable work. Obligatory reading.
60. Ponticelli C, Rizzoni G, Edefonti A, et al. A randomized trial of cyclosporine in steroid-resistant idiopathic nephrotic syndrome. Kidney Int 1993;43:1377-1384 •• One of the too rare randomized trials. (Pubitemid 23161428)
61. Niaudet P. French Society of Pediatrics. Treatment of childhood steroid-resistant idiopathic nephrosis with a combination of cyclosporine and prednisone. J Pediatr 1994;125:981-986 (Pubitemid 24379137)
62. Meyrier A, Noël LH, Auriche P, Callard P. Long-term renal tolerance of cyclosporin A treatment in adult idiopathic nephrotic syndrome. Kidney Int 1994;45:1446-1456 •• The only large scale study on repeat renal biopsies in CsA treated patients with idiopathic nephrotic syndrome. (Pubitemid 24135033)
63. Cattran DC, Alexopoulos E, Heering P, et al. Cyclosporin in idiopathic glomerular disease associated with the nephrotic syndrome: workshop recommendations. Kidney Int 2007;72:1429-1447 •• An exhaustive update and useful guidelines on the treatment of idiopathic nephrotic FSGs with CsA. (Pubitemid 350197945)
64. Ingulli E, Tejani A. Severe hypercholesterolemia inhibits cyclosporin A efficacy in a dose-dependent manner in children with nephrotic syndrome. J Am Soc Nephrol 1992;3:254-259
65. Ponticelli C, Villa M, Banfi G, et al. Can prolonged treatment improve the prognosis in adults with focal segmental glomerulosclerosis? Am J Kidney Dis 1999;34:618-625
66. McCauley J, Shapiro R, Ellis D, et al. Pilot trial of FK 506 in the management of steroid-resistant nephrotic syndrome. Nephrol Dial Transplant 1993;8:1286-1290 (Pubitemid 23342670)
67. Segarra A, Vila J, Pou L, et al. Combined therapy of tacrolimus and corticosteroids in cyclosporin-resistant or -dependent idiopathic focal glomerulosclerosis: a preliminary uncontrolled study with prospective follow-up. Nephrol Dial Transplant 2002;17:655-662 (Pubitemid 34308823)
68. Loeffler K, Gowrishankar M, Yiu V. Tacrolimus therapy in pediatric patients with treatment resistant nephrotic syndrome. Pediatr Nephrol 2004;19:281-287 (Pubitemid 38313011)
69. Duncan N, Dhaygude A, Owen J, et al. Treatment of focal and segmental glomerulosclerosis in adults with tacrolimus monotherapy. Nephrol Dial Transplant 2004;19:3062-3067 (Pubitemid 40057629)
70. Westhoff TH, Van der Giet M. Tacrolimus in the treatment of idiopathic nephrotic syndrome. Expert Opin Investig Drugs 2007;16:1099-1110 •• A comprehensive update. (Pubitemid 47074164)
71. Gulati S, Prasad N, Sharma RK, et al. Tacrolimus: a new therapy for steroid-resistant nephrotic syndrome in children. Nephrol Dial Transplant 2008;23:910-913 (Pubitemid 351767558)
72. Sinha MD, MacLeod R, Rigby E, Clark AG. Treatment of severe steroid-dependent nephrotic syndrome (SDNS) in children with tacrolimus. Nephrol Dial Transplant 2006;21:1761-1763 (Pubitemid 43985712)
73. Bhimma R, Adhikari M, Asharam K, Connolly C. Management of steroid-resistant focal segmental glomerulosclerosis in children using tacrolimus. Am J Nephrol 2006;26:554-641 (Pubitemid 46143876)
74. Tumlin JA, Miller D, Near M, et al. A prospective open-label trial of sirolimus in the treatment of focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 2006;1:109-116
75. Fervenza FC, Fitzpatrick PM, Mertz J, et al. Acute rapamycine nephrotoxicity in native kidneys of patients with chronic glomerulonephritis. Nephrol Dial Transplant 2004;19:1288-1292 •• Important caveat. (Pubitemid 38628153)
76. Letavernier E, Bruneval P, Mandet C, et al. High sirolimus levels may induce focal segmental glomerulosclerosis de novo. Clin J Am Soc Nephrol 2007;2:326-333
77. Linshaw MA, Gruskin AB. Management of the nephrotic syndrome. A summary of progress in the use of immunosuppressive therapy. Clin Pediatr 1974;13:45-51
78. Cade R, Mars D, Privette M, et al. Effect of long-term azathioprine administration in adults with minimal-change glomerulonephritis and nephrotic syndrome resistant to corticosteroids. Arch Int Med 1986;146:737-741 (Pubitemid 16037691)
79. Briggs WA, Choi MJ, Scheel PJ Jr. Successful mycophenolate mofetil treatment of glomerular disease. Am J Kidney Dis 1998;31:213-217 (Pubitemid 28106410)
80. Choi MJ, Eustace JA, Gimenez LF, et al. Mycophenolate mofetil for primary glomerular diseases. Kidney Int 2002;61:1098-1114 (Pubitemid 34175479)
81. Barletta GM, Smoyer WE, Bunchman TE, et al. Use of mycophenolate mofetil in steroid-dependent and -resistant nephrotic syndrome. Pediatr Nephrol 2003;18:833-837 (Pubitemid 36949975)
82. Bagga A, Hari P, Moudgil A, Jordan SC. Mycophenolate mofetil and prednisolone therapy in children with steroid-dependent nephrotic syndrome. Am J Kidney Dis 2003;42:1114-1120 (Pubitemid 37486753)
83. Gellerman J, Querfeld U. Frequently relapsing nephrotic syndrome: treatment with mycophenolate mofetil. Pediatr Nephrol 2004;19:101-104 (Pubitemid 38088259)
84. Cattran DC, Wang MM, Appel G, et al. Mycophenolate mofetil in the treatment of focal segmental glomerulosclerosis. Clin Nephrol 2004;62:405-411 (Pubitemid 39654577)
85. Segarra A, Amoedo ML, Martinez Garcia JM, et al. Efficacy and safety of 'rescue therapy' with mycophenolate mofetil in resistant primary glomerulonephritis - a multicentre study. Nephrol Dial Transplant 2007;22:1351-1360 •• An excellent contribution.
86. Plosker JL, Figgit DP. Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia. Drugs 2003;63:803-843 (Pubitemid 36432084)
87. Ahmed MS, Wong CF. Rituximab and nephrotic syndrome: a new therapeutic hope? Nephrol Dial Transplant 2008;23:11-17
88. Pescovitz M, Book BK, Sidner RA. Resolution of recurrent focal segmental glomerulosclerosis proteinuria after rituximab treatment. N Engl J Med 2006;354:1961-3 •• The 'seminal paper' on rituximab.
89. Gossmann J, Scheuermann EH, Porubsky S, et al. Abrogation of nephrotic proteinuria by rituximab treatment in a renal transplant patient with relapsed focal segmental glomerulosclerosis. Transpl Int 2007;20:558-562 (Pubitemid 46701081)
90. Suri M, Tran K, Sharma AP, et al. Remission of steroid-resistant nephrotic syndrome due to focal and segmental glomerulosclerosis using rituximab. Int Urol Nephrol 2008;40:807-810
91. Nakayama M, Kamei K, Nozu K, et al. Rituximab for refractory focal segmental glomerulosclerosis. Pediatr Nephrol 2008;23:481-485
92. Guigonis V, Dallocchio A, Baudouin V, et al. Rituximab treatment for severe steroid- or cyclosporine-dependent nephrotic syndrome: a multicentric series of 22 cases. Pediatr Nephrol 2008;23:1269-1279
93. Kurosaki T. Paradox of B cell-targeted therapies. J Clin Invest 2008;118:3260-3263
94. Yokoyama H, Wada T, Zhang W, et al. Advances in apheresis therapy for glomerular diseases. Clin Exp Nephrol 2007;11:122-127 (Pubitemid 47012509)
95. Feld S, Figueroa P, Savin V, et al. Plasmapheresis in the treatment of steroid-resistant focal segmental glomerulosclerosis. Am J Kidney Dis 1998;32:230-237 (Pubitemid 128719290)
96. Artero M, Biava C, Amend W, et al. Recurrent focal glomerulosclerosis: natural history and response to therapy. Am J Med 1992;92:375-383
97. Swaminathan S, Lager DJ, Qian X, et al. Collapsing and non-collapsing focal segmental glomerulosclerosis in kidney transplants. Nephrol Dial Transplant 2006;21:2607-2614 (Pubitemid 44644539)
98. Gooh RY, Yango AF, Morrissey PE, et al. Preemptive plasmapheresis and recurrence of FSGS in high-risk renal transplant recipients. Am J Transplant 2005;5:2907-2912 (Pubitemid 43923951)
99. Dantal J, Bigot E, Bogers W, et al. Effect of plasma protein adsorption in kidney-transplant recipients with recurrent nephrotic syndrome. N Engl J Med 1994;330:7-14 (Pubitemid 24018610)
100. Esnault VL, Besnier D, Testa A, et al. Effect of protein A immunoadsorption in nephrotic syndrome of various etiologies. J Am Soc Nephrol 1999;10:2014-2017 (Pubitemid 29402524)
101. Kuhn C, Kuhn A, Markau S, et al. Effect of immunoadsorption on refractory idiopathic focal and segmental glomerulosclerosis. J Clin Apher 2006;21:266-270 (Pubitemid 46034443)