What is the recurrence/prognosis of IgA nephropathy after renal transplant?

Bottom Line: In this study, at least 35% of patients had biopsy-proven recurrence.

Reference: Ponticelli C, et al.  Kidney transplant in patients with IgA mesangial glomerulonephritis.  Kidney International 60 (2001), 1948-54.

Summary: METHODS-Case-control study of 106 adults transplanted because of a biopsy-proven IgAGN and of 212 patients without IgAGN transplanted during the same period.  Evaluated the risk of recurrence, patients with hematuria, proteinuria, or an increase in plasma creatinine.  RESULTS-The ten-year patient (0.93 vs. 0.92) and graft survival (0.75 vs. 0.82) probabilities were not significantly different between IgAGN patients and controls. Only plasma creatinine and proteinuria at six months were associated with an increased relative risk (RR) of graft failure (RR 2.79 and 5.94, respectively).  Histological recurrence of IgA glomerulonephritis was diagnosed in 37 patients.  Younger age (RR 2.63), increased plasma creatinine (RR 2.39), and proteinuria (RR 6.02) at six months were associated with the risk of recurrence.  The main causes of graft failure were glomerulonephritis in patients with recurrence of IgAGN and chronic rejection in patients without recurrence.

Repost of July 19, 2010

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