Clinical outcomes of kidney transplants on patients with end-stage renal disease secondary to lupus nephritis, polycystic kidney disease and diabetic nephropathy

Abstract

Background: Patients with lupus nephritis could progress to end-stage renal disease (10-22%); hence, kidney transplants should be considered as the treatment of choice for these patients. Objective: To evaluate the clinical outcomes after kidney transplants in patients with chronic kidney diseases secondary to lupus nephritis, polycystic kidney disease and diabetes nephropathy at Pablo Tobon Uribe Hospital. Methods: A descriptive and retrospective study performed at one kidney transplant center between 2005 and 2013. Results: A total of 136 patients, 27 with lupus nephritis (19.9%), 31 with polycystic kidney disease (22.8%) and 78 with diabetes nephropathy (57.4%), were included in the study. The graft survivals after one, three and five years were 96.3%, 82.5% and 82.5% for lupus nephritis; 90%, 86% and 76.5% for polycystic kidney disease and 91.7%, 80.3% and 67.9% for diabetes nephropathy, respectively, with no significant differences (p= 0.488); the rate of lupus nephritis recurrence was 0.94%/person-year. The etiology of lupus vs diabetes vs polycystic disease was not a risk factor for a decreased time of graft survival (Hazard ratio: 1.43; 95% CI: 0.52-3.93). Conclusion: Kidney transplant patients with end stage renal disease secondary to lupus nephritis has similar graft and patient survival success rates to patients with other kidney diseases. The complication rate and risk of recurrence for lupus nephritis are low. Kidney transplants should be considered as the treatment of choice for patients with end stage renal disease secondary to lupus nephritis.

Outcome and Prognosis of Patients With Lupus Nephritis Submitted to Renal Transplantation

“…Renal transplantation is a viable treatment option for patients with end-stage CKD and LN 3–6 , and the risk of graft failure is similar in renal transplantation patients with and without SLE 5,6 . Moreover, the rates of LN-related complications and recurrence are low 7 .…”

Combination of Ginsenoside Rg1 and Astragaloside IV reduces oxidative stress and inhibits TGF-β1/Smads signaling cascade on renal fibrosis in rats with diabetic nephropathy

“…Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus (DM) which leads to end-stage renal failure in 30%–40% of DM patients. 1 – 3 The incidence of DN will rapidly increase with increase in the incidence of DM in China in the decades to come. 4 , 5 Oxidative stress injury and TGF-β/Smads signal transduction are vital to the development and progression of DN.…”

Renal Transplantation and Survival Among Patients With Lupus Nephritis

“…However, concerns have arisen about potentially worse outcomes after renal transplant among patients with LN-ESRD, relating to certain SLE features and associated treatments (10,11,(25)(26)(27). For example, some studies (although not all [28][29][30]) have suggested higher rates of allograft failure among patients with LN-ESRD than among those with other causes of ESRD (10,11,25,27). Patients with LN-ESRD may have higher risk for infection due to the intensive immunosuppression used to treat LN and other disease manifestations (31).…”