A clinicopathological study of IgA nephropathy in renal transplant recipients: beneficial effect of angiotensin‐converting enzyme inhibitor

Oka, Kunihiro; Imai, Enyu; Moriyama, Toshiki; Akagi, Yuya; Ando, Akio; Hori, Masatsugu; Okuyama, Äkïhïko; Toki, Kiyohide; Kyo, Masahiro; Kokado, Yukito; Takahara, Shiro

doi:10.1093/ndt/15.5.689

Cited by 80 publications

(59 citation statements)

References 32 publications

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“…Considering the average time to posttransplantation biopsy (3.6 years) and the low prevalence of chronic rejection, it seems that glomerular hypertrophy [23] and segmental glomerulosclerosis are major factors in the development of proteinuria in patients with recurrent IgAN. Of recurrent IgAN patients, 63.6% were treated with angiotensin-converting enzyme inhibitors or receptor blockers at the time of biopsy, which could have affected urinary protein excretion [21,24].…”

Section: Discussionmentioning

confidence: 99%

Progression of renal allograft histology after renal transplantation in recurrent and nonrecurrent immunoglobulin A nephropathy

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Progression of renal allograft histology after renal transplantation in recurrent and nonrecurrent immunoglobulin A nephropathy

et al. 2008

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“…22 Our previous study of posttransplant IgA patients suggests that the glomerular size reaches a plateau 3 years after transplantation. 8 Morphological analyses of biopsy specimens from renal allografts also suggest that glomerular hypertension/hyperfiltration occurs soon after renal transplantation. Accordingly, it is quite reasonable to speculate that ACEI administration should be started immediately after transplantation to prevent glomerular hypertension/ hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

“…7 Previously, we demonstrated the safety and effectiveness of ACEI treatment on hypertensive proteinuric posttransplant patients (n ϭ 10) who were followed up for 12 months. 8 The purpose of the present study was to determine the safety and therapeutic value of an ACEI (benazepril) on blood pressure (BP), renal function, and proteinuria in a randomized prospective analysis of posttransplant patients.…”

Section: Introductionmentioning

confidence: 99%

Randomized prospective study of effects of benazepril in renal transplantation: an analysis of safety and efficacy

Takahara

Moriyama

Kokado

et al. 2002

Clinical and Experimental Nephrology

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Background. Prolonging the survival of transplanted kidneys is one of major tasks of modern nephrology. Angiotensin-converting enzyme inhibitors (ACEIs) compose a class of antihypertensive agents that has established efficacy in the treatment of hypertension and in slowing the progression of diabetic nephropathy and chronic glomerulonephritis. ACEIs are not widely accepted as a standard medication in the treatment of hypertension in renal transplant recipients because of the potential risk for decreased renal blood flow and glomerular filtration rate associated with a single kidney and concomitant cyclosporin use. Methods. We undertook a prospective randomized study of ACEI (benazepril) treatment in 76 posttransplant patients to determine the safety, efficacy, and side-effect profile of benazepril. Forty-one patients were assigned to the benazepril group and 35 patients were assigned to the control group. Results. The mean arterial blood pressure at a 12-month follow-up was lower than that at the time of initiation of benazepril or control therapy, with a decrease from 101 Ϯ 10 mmHg to 94 Ϯ 7 mmHg (P Ͻ 0.05) in the benazepril group and from 102 Ϯ 12 mmHg to 94 Ϯ 10 mmHg in the control group after 12 months of treatment. The serum creatinine concentrations did not change throughout the follow-up period. Conclusions. Benazepril was demonstrated to be an effective antihypertensive without any unfavorable effects on graft function. A significant antiproteinuric effect of benazepril was observed in patients with overt proteinuria. Further follow-up of this patient population will contribute to the establishment of the long-term renoprotective effect of benazepril in renal allograft recipients.

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“…Risk factors associated with recurrent IgA vasculitis include shorter duration of the original disease, a living related donor, and necrotizing/crescent glomerulonephritis of the native kidneys [140]. No specific therapy for IgAN and IgA vasculitis recurrence is available; guidelines recommend using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ ARBs) [141]. No immunosuppressive regimen has been shown to be superior [142].…”

Section: Recurrent Diseasementioning

confidence: 99%

Histopathological findings in transplanted kidneys

et al. 2017

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Improvements in immunosuppression have reduced acute kidney allograft rejection and clinicians are now seeking ways to prolong allograft survival to 20 years and beyond. The primary cause of kidney allograft loss is still chronic rejection, followed by death with a functioning allograft and primary kidney disease recurrence. Thus, overcoming kidney allograft rejection remains the most important issue. Kidney allograft rejection can be classified into two types: T cell-and antibody-mediated rejection. Both are diagnosed pathologically based on the Banff 2013 classification. Other important pathological features in addition to rejection include calcineurin inhibitor toxicity, polyomavirus nephropathy, and recurrence of the primary kidney disease. Here, we review the diagnosis and representative features of histopathological findings in transplanted kidneys.

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A clinicopathological study of IgA nephropathy in renal transplant recipients: beneficial effect of angiotensin‐converting enzyme inhibitor

Cited by 80 publications

References 32 publications

Progression of renal allograft histology after renal transplantation in recurrent and nonrecurrent immunoglobulin A nephropathy

Progression of renal allograft histology after renal transplantation in recurrent and nonrecurrent immunoglobulin A nephropathy

Randomized prospective study of effects of benazepril in renal transplantation: an analysis of safety and efficacy

Histopathological findings in transplanted kidneys

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