Prevalence and Prognosis of Post-transplant Glomerulonephritis in Kidney Transplant Biopsies, A Single- Center Report.

IF 0.8 4区医学 Q4 UROLOGY & NEPHROLOGY Iranian journal of kidney diseases Pub Date : 2023-03-01

Roghayeh Jafari, Mitra Mehrazma, Mohsen Vahedi, Shahrzad Ossareh

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Abstract

Introduction: Recurrence of glomerulonephritis (GN) after kidney transplant (Tx) may be associated with allograft loss. This study aimed to evaluate the frequency and prognosis of de novo or recurrent post-Tx GN.

Methods: We reviewed 1305 kidney Tx biopsy samples obtained between 2006 and 2020. The biopsy specimens were divided into post-Tx GN (recurrent or de novo) and control groups (i.e., no detectable GN in biopsy). Demographic and baseline characteristics of the patients and kidney survival rates were analyzed.

Results: From 1305 kidney transplanted biopsies, 350 repeated biopsies for transplant rejection were excluded. Among 955 analyzed biopsies, (mean age: 40.4 ± 13.48 years, mean transplantation duration: 4.54 ± 3.98 years, 74.6% males), the frequency of GN was 10.78%. The most common recurrent post-Tx GN was IgA nephropathy (22.3%), followed by secondary focal segmental glomerulonephritis (FSGS, 19.4%), primary FSGS (19.4%), and membranous glomerulonephritis (17.5%). In the post-Tx GN group, the mean serum creatinine and proteinuria were 3.28 ± 1.97 mg/dL and 2730 ± 1244 mg/d at the biopsy time and 4.14 ± 1.86 mg/dL and 2020 ± 1048 mg/d, at the end of the study. There was a significant relationship between baseline serum creatinine and graft loss (P < .001). One-, five-, and ten-year graft survival rates were 97%, 81%, and 63% in the postTx GN, and 100%, 92%, and 59% in the control group. The median time to graft loss after biopsy, (graft survival after biopsy), was significantly lower in the post-Tx GN group (P < .000). The other accompanying factors had no significant impact on graft survival.

Conclusion: The median time to graft loss after biopsy was significantly lower in post-Tx GN. Baseline serum creatinine had a significant association with graft loss. Optimal management of recurrent or de novo GN should be a main focus of post-transplant care. DOI: 10.52547/ijkd.7205.

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肾移植活检中移植后肾小球肾炎的患病率和预后:一份单中心报告。

肾移植(Tx)后肾小球肾炎(GN)的复发可能与同种异体移植损失有关。本研究旨在评估重新发生或复发的tx后GN的频率和预后。方法:我们回顾了2006年至2020年间获得的1305例肾Tx活检样本。活检标本分为tx后GN(复发或新生)和对照组(即活检中未检测到GN)。分析患者的人口统计学和基线特征以及肾脏存活率。结果:在1305例肾移植活检中，排除了350例移植排斥反应的重复活检。955例活检中(平均年龄40.4±13.48岁，平均移植时间4.54±3.98年，男性占74.6%)，GN发生率为10.78%。最常见的tx后GN复发是IgA肾病(22.3%)，其次是继发性局灶节段性肾小球肾炎(FSGS, 19.4%)，原发性FSGS(19.4%)和膜性肾小球肾炎(17.5%)。在tx GN后组，活检时平均血清肌酐和蛋白尿分别为3.28±1.97 mg/dL和2730±1244 mg/d，研究结束时平均血清肌酐和蛋白尿分别为4.14±1.86 mg/dL和2020±1048 mg/d。基线血清肌酐与移植物损失有显著相关性(P < 0.001)。移植后1年、5年和10年的存活率分别为97%、81%和63%，对照组为100%、92%和59%。活检后移植物损失的中位时间(活检后移植物存活)在tx GN组中显著降低(P < .000)。其他相关因素对移植物存活无显著影响。结论:术后GN活检后移植物丢失的中位时间显著缩短。基线血清肌酐与移植物损失显著相关。对复发性或新发GN的最佳管理应是移植后护理的主要重点。DOI: 10.52547 / ijkd.7205。

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来源期刊

Iranian journal of kidney diseases UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.