Recurrencia de glomerulonefritis postrasplante renal: características clínico-patológicas

Introduction

Glomerulonephritis (GN) is one of the main causes of end-stage renal disease worldwide and therefore a frequent cause of kidney transplantation, with the possibility of recurrence of GN (Recurrent Glomerulonephritis [GNR]) in the transplanted kidney. The purpose of this study was to identify the clinic and pathological characteristics of GNR in a population of transplant patients.

Materials and methods

A descriptive, retrospective study was carried out in 109 patients in whom GNR was documented in the transplanted kidney demonstrated by biopsy during the period between 1998-2021.

Results

Of 109 patients, the most frequent GNR was GNIgA, in 38.5% (42), followed by FSGS with 31.2% (34); These same entities were the ones that presented the greatest graft dysfunction, with 50% (21) and 26.2% (11) respectively. The ranges of proteinuria indicated by the biopsy were 31.2% (34) with a range of 500 to 3500 mg/24 h and 34.9% (38) with proteinuria > 3500 mg/24 h. In relation to the time elapsed between the transplant and the diagnosis of GNR, 33% (36) of the cases were > 5 years, followed by 1 to 5 years in 26.6% (29). Recurrence in patients with GNIgA occurred mostly after 5 years post-transplant with 45.2% (19) and for FSGS it was between 1 and 6 months.

Conclusion

We found a general frequency of GNR presentation similar to those reported by other centers where biopsies are performed for clinical indication, finding that the GN that recurred most frequently are GNIgA and FSGS.