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- Title
IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch.
- Authors
Rodas, Lida M.; Ruiz-Ortiz, Estibaliz; Garcia-Herrera, Adriana; Pereira, Arturo; Blasco, Miquel; Ventura-Aguiar, Pedro; Viñas Gomis, Odette; Egri, Natalia; De Sousa, Erika; Palou, Eduard; Diekmann, Fritz; Poch, Esteban; Campistol, Josep M.; Quintana, Luis Fernando; Rodas, Lida M; Viñas Gomis, Odette; De Sousa, Erika; Campistol, Josep M; Quintana, Luis Fernando
- Abstract
<bold>Background: </bold>Recurrence of immunoglobulin (Ig)A nephropathy (rIgAN) is a growing cause of kidney allograft dysfunction. This study was aimed at investigating factors associated with rIgAN and the subsequent progression to end-stage renal disease (ESRD).<bold>Methods: </bold>Retrospective study including consecutive patients with IgA nephropathy (IgAN) who received a kidney transplant in our center between 1992 and 2016 and had a renal biopsy by clinical indication. The date of detection of chronic kidney disease (CKD) 5 was used as renal outcome.<bold>Results: </bold>Eighty-six kidney transplants were performed in patients with IgAN, 38 (44%) were from living donors (related n = 26). rIgAN was diagnosed in 23 allografts (27%). Renal function and proteinuria at the end of the follow-up period were worst in the rIgAN patients compared to those without rIgAN (2.2 vs. 1.4 mg/dL, p = 0.014, and 1.16 vs. 0.49 g/day, p = 0.005, respectively). Risk of rIgAN and progression to CKD 5 decreased with patient's age (hazard ratio [HR] 0.95, 95% CI 0.92-0.98, p = 0.002, and HR 0.97, 95% CI 0.83-0.97, p = 0.008 per year, respectively). Patients with rIgAN had a higher risk of progression to CKD 5 (HR 6.7, 95% CI 1.3-35.7, p = 0.025). Full donor-recipient mismatch in the human leukocyte antigen (HLA)-B loci decreased the risk of rIgAN (HR 0.22, 95% CI 0.06-0.76, p = 0.017).<bold>Conclusions: </bold>rIgAN was an independent risk factor for ESRD after renal allograft. Younger age increased the risk of rIgAN and CKD 5. Conversely, HLA-B mismatching was a potential protective factor for rIgAN of this glomerular disease.
- Subjects
IGA glomerulonephritis; KIDNEY transplantation; HLA histocompatibility antigens; CHRONIC kidney failure; BK virus; LEUCOCYTES; DISEASE progression; RESEARCH; HLA-B27 antigen; HOMOGRAFTS; KIDNEYS; BIOPSY; AGE distribution; RESEARCH methodology; RETROSPECTIVE studies; HISTOCOMPATIBILITY testing; MEDICAL cooperation; EVALUATION research; DISEASE relapse; COMPARATIVE studies; GLOMERULONEPHRITIS; PROBABILITY theory; LONGITUDINAL method; DISEASE complications
- Publication
American Journal of Nephrology, 2020, Vol 51, Issue 5, p357
- ISSN
0250-8095
- Publication type
journal article
- DOI
10.1159/000506853