Table 1.
Characteristics of Five Patients with Focal Segmental Glomerulosclerosis (FSGS).
| Variable | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 |
|---|---|---|---|---|---|
| Age and sex | 28-yr-old woman | 19-yr-old woman | 14-yr-old boy | 7-yr-old boy | 27-yr-old woman |
| Kidney donor | Living related donor; earlier transplant from a living related donor failed owing to recurrent FSGS | Cadaveric donor; earlier transplant from a living related donor failed owing to recurrent FSGS | Living related donor | Cadaveric donor | No donor (native kidney) |
| Induction immunosuppression | Daclizumab (1 mg/kg, two doses), antithymocyte globulin (1 mg/kg, five doses), rituximab (375 mg/m2, one dose) | Daclizumab (1 mg/kg, two doses), antithymocyte globulin (1 mg/kg, five doses), rituximab (375 mg/m2, one dose) | Antithymocyte globulin (1 mg/kg, five doses), basiliximab (10 mg/kg, two doses), rituximab (375 mg/m2, one dose) | Antithymocyte globulin (1 mg/kg, five doses), basiliximab (10 mg/kg, two doses), rituximab (375 mg/m2, one dose) | |
| Maintenance immunosuppression | Tacrolimus (target serum level, 5–7 ng/ml), mycophenolate mofetil (500 mg twice daily), glucocorticoids | Tacrolimus (target serum level, 5–7 ng/ml), mycophenolate mofetil (500 mg twice daily), glucocorticoids | Tacrolimus (target serum level, 5–7 ng/ml), mycophenolate mofetil (125–250 mg twice daily), glucocorticoids | Tacrolimus (target serum level, 5–7 ng/ml), mycophenolate mofetil (125–250 mg twice daily), glucocorticoids | |
| Treatment for FSGS before abatacept therapy | Plasmapheresis | Plasmapheresis | Plasmapheresis | Plasmapheresis | Prednisone, cyclosporine, tacrolimus |
| Abatacept therapy | Single dose (10 mg/kg) | Single dose (10 mg/kg) | Two doses (10 mg/kg) | Two doses (10 mg/kg) | 10 mg/kg on days 1, 15, and 30 and monthly thereafter |
| Most recent laboratory test results* | 48-mo follow-up (February 2013): serum albumin, 3.4 g/dl; serum creatinine, 1.3 mg/dl; urinary protein-to-creatinine ratio, 0.50 | 36-mo follow-up (February 2013): serum albumin, 3.8 g/dl; serum creatinine, 0.7 mg/dl; urinary protein-to-creatinine ratio, 0.41 | 12-mo follow-up (February 2013): serum albumin, 4.0 g/dl; serum creatinine, 0.9 mg/dl; urinary protein-to-creatinine ratio, 0.08 | 10-mo follow-up (March 2013): serum albumin, 4.3 g/dl; serum creatinine, 0.3 mg/dl; urinary protein-to-creatinine ratio, 0.05 | 12-mo follow-up (October 2013): serum albumin, 3.8 g/dl; serum creatinine, 0.4 mg/dl; urinary protein-to-creatinine ratio, 0.50 |
To convert values for creatinine to micromoles per liter, multiply by 88.4. A urinary protein-to-creatinine ratio of less than 0.15 is considered normal.