Post-Transplant Glomerulonephritis: Challenges and Solutions.

IF 2.1 Q2 UROLOGY & NEPHROLOGY International Journal of Nephrology and Renovascular Disease Pub Date : 2024-03-15 eCollection Date: 2024-01-01 DOI:10.2147/IJNRD.S391779
Marcos Vinicius de Sousa
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Abstract

Glomeruli can be damaged in several conditions after kidney transplantation, with a potential impact on the graft function and survival. Primary glomerulonephritis, a group of glomerular immunological damage that results in variable histological patterns and clinical phenotypes, can occur in kidney transplant recipients as a recurrent or de novo condition. Specific immunologic conditions associated with kidney transplantation, such as acute rejection episodes, can act as an additional trigger after transplantation, impacting the incidence of these glomerulopathies. The post-transplant GN recurrence ranges from 3% to 15%, varying according to the GN subtype and post-transplant time, mainly occurring after 3-5 years of kidney transplantation. Advances in the knowledge of glomerulonephritis pathophysiology have provided new approaches to pre-transplant risk evaluation and post-transplant monitoring. Glomeruli can be affected by several systemic viral infections, such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), cytomegalovirus (CMV), and BK virus. The diagnosis of these infections, as well as the identification of possible complications associated with them, are important to minimize the negative impacts of these conditions on kidney transplant recipients' outcomes.

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移植后肾小球肾炎:挑战与解决方案。
肾移植后,肾小球可能会在多种情况下受损,从而对移植肾的功能和存活造成潜在影响。原发性肾小球肾炎是一组肾小球免疫损伤,可导致不同的组织学模式和临床表型,可作为复发性或新发病症出现在肾移植受者身上。与肾移植相关的特定免疫条件,如急性排斥反应,可作为肾移植后的额外诱因,影响这些肾小球疾病的发病率。移植后 GN 复发率为 3% 至 15%,因 GN 亚型和移植后时间而异,主要发生在肾移植 3-5 年后。肾小球肾炎病理生理学知识的进步为移植前风险评估和移植后监测提供了新方法。肾小球可能受到多种全身性病毒感染的影响,如人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)、严重急性呼吸系统综合征冠状病毒 2(SARS-COV-2)、巨细胞病毒(CMV)和 BK 病毒。这些感染的诊断以及与之相关的可能并发症的识别对于最大限度地减少这些疾病对肾移植受者预后的负面影响非常重要。
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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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