Outcome of 313 Czech Patients With IgA Nephropathy After Renal Transplantation

Maixnerová, Dita; Hrubá, Petra; Neprašová, Michaela; Bednarova, Kamila; Slatinska, Janka; Suchánek, Miloslav; Kollár, Marek; Novák, Jan; Tesař, Vladimı́r; Viklický, Ondřej

doi:10.3389/fimmu.2021.726215

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…found that the living donor was not related to the recurrent IgAN [24]. Our study showed that living donor transplantation increased the risk of recurrence of IgAN after renal transplantation, especially the living related donor (P < 0.05).…”

Section: Discussionmentioning

confidence: 48%

Risk factors for recurrent IgA nephropathy after renal transplantation: A meta-analysis

Bai

Chen

et al. 2022

Bosn J of Basic Med Sci

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Recurrent glomerulonephritis after renal transplantation is the third most common cause of allograft loss, the most frequent of which is associated with IgA nephropathy (IgAN). This study aims to provide a systematic review of the risk factors associated with recurrent IgAN after renal transplantation. We searched English and Chinese databases, including PubMed, Embase, Web of Science, CNKI, and others, and included all case-control studies involving risk factors for recurrent IgAN after renal transplantation from the databases’ establishment to March 2022. Data were analyzed using the Stata 12.0. A total of 20 case–control studies were included in the meta-analysis, with 542 patients with recurrent IgAN and 1385 patients without recurrent IgAN. The results showed that donor age (standardized mean difference [SMD] -0.13 [95% CI -0.26, -0.001]; P = 0.048), patient age at transplantation (SMD -0.41 [95% CI -0.53, -0.29]; P < 0.001), time from diagnosis to end-stage renal disease (SMD -0.42 [95% CI -0.74, -0.10]; P = 0.010), previous transplantation (odds ratio [OR] 1.73 [95% CI 1.06, 2.81]; P = 0.027), living donor (OR 1.86 [95% CI 1.34, 2.58]; P < 0.001), related donor (OR 2.64, [95% CI 1.84, 3.79]; P < 0.001), tacrolimus use (OR 0.71 [95% CI 0.52, 0.98]; P = 0.035), basiliximab use (OR 0.39 [95% CI 0.27, 0.55]; P < 0.001), proteinuria (SMD 0.42 [95% CI 0.13, 0.71]; P = 0.005) and serum IgA level (SMD 0.48 [95% CI 0.27, 0.69]; P < 0.001) were associated with recurrent IgAN after renal transplantation. In general, tacrolimus and basiliximab use were protective factors against recurrent IgAN after renal transplantation, whereas donor age, patient age at transplantation, time from diagnosis to end-stage renal disease, previous transplantation, living donor, related donor, proteinuria, and serum IgA level were risk factors for recurrent IgAN after renal transplantation. Clinical decision making should warrant further consideration of these risk factors.

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Section: Discussionmentioning

confidence: 48%

Risk factors for recurrent IgA nephropathy after renal transplantation: A meta-analysis

Bai

Chen

et al. 2022

Bosn J of Basic Med Sci

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“…Several risk factors were documented in the literature that are associated with high recurrence rates, including receiving a living donor kidney, HLA matching, a younger age at transplant, and so on . 1,3,19 In 313 patients with IgAN with a follow-up of up to 36 y, Maixnerova et al 20 used the hierarchical clustering method to identify risk factors of recurrence and outcome. Patients with graft failure (n = 50) were divided into 2 groups based on the mean time from kidney transplant to graft failure (11.2 versus 6.1 y).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Modified Oxford Score in Recurrent IgA Nephropathy in North American Kidney Transplant Recipients: The Banff Recurrent Glomerulonephritis Working Group Report

et al. 2023

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Background. The modified Oxford classification mesangial and endocapillary hypercellularity, segmental sclerosis, interstitial fibrosis/tubular atrophy, and the presence of crescents (MEST-C) of immunoglobulin A nephropathy (IgAN) was recently shown to be a predictor of graft failure in Asians with recurrent IgAN. We aimed to validate these findings in a cohort from North American centers participating in the Banff Recurrent Glomerulopathies Working Group. Methods. We examined 171 transplant recipients with end-stage kidney disease because of IgAN; 100 of them with biopsy-proven recurrent IgAN (57 of them had complete MEST-C scores) and 71 with no recurrence. Results. IgAN recurrence, which was associated with younger age at transplantation (P = 0.012), strongly increased the risk of death-censored graft failure (adjusted hazard ratio, 5.10 [95% confidence interval (CI), 2.26-11.51]; P < 0.001). Higher MEST-C score sum was associated with death-censored graft failure (adjusted hazard ratio, 8.57 [95% CI, 1.23-59.85; P = 0.03] and 61.32 [95% CI, 4.82-779.89; P = 0.002] for score sums 2–3 and 4–5 versus 0, respectively), and so were the single components endocapillary hypercellularity, interstitial fibrosis/tubular atrophy, and crescents (P < 0.05 each). Overall, most of the pooled adjusted hazard ratio estimates associated with each MEST-C component were consistent with those from the Asian cohort (heterogeneity I2 close to 0%, and P > 0.05). Conclusions. Our findings may validate the prognostic usefulness of the Oxford classification for recurrent IgAN and support the inclusion of the MEST-C score in allograft biopsies diagnostic reports.

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“…Reports of recurrent disease in IgAN are variable and time-dependent [25,26 ▪▪ ], with an estimated 13–25% of patients experiencing recurrence by 5 years, and as high as 60% by 15 years. Variability likely depends on whether centers practice protocol surveillance biopsies or not.…”

Section: Iga Nephritis and Iga Vasculitismentioning

confidence: 99%

“…Variability likely depends on whether centers practice protocol surveillance biopsies or not. Median time to recurrence has been reported at 3–4 years [23 ▪▪ ,26 ▪▪ ,27 ▪ ,28 ▪ ,29]. Pediatric patients are at higher risk of recurrence than adults [25,30].…”

Section: Iga Nephritis and Iga Vasculitismentioning

confidence: 99%

Kidney transplantation in pediatric patients with rheumatologic disorders

Cody

Hooper

2021

Current Opinion in Pediatrics

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Purpose of reviewProviders caring for children with end-stage kidney disease from rheumatologic conditions face questions such as when to proceed with kidney transplantation, how common is disease recurrence posttransplant, how does recurrent disease impact patient and allograft outcomes, and what approaches are available to prevent and treat recurrent disease. We discuss recent developments and relevant literature that address these questions for the most common rheumatologic disorders that lead to end-stage kidney disease in childhood namely, systemic lupus erythematosus, IgA nephropathy, IgA Vasculitis/Henoch Schoenlein Purpura, and Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis.Recent findingsRecent data suggest that children with IgA nephropathy, IgA vasculitis, and ANCA-associated vasculitis have similar patient and allograft survival to other conditions despite the risk of recurrent disease, yet those with lupus have worse posttransplant patient and allograft outcomes. A period of disease quiescence may be prudent prior to transplantation to decrease the risk of recurrence, which is associated with decreased allograft survival. Data on preventive strategies and treatment options are limited.SummaryIt is recommended that patients with systemic rheumatologic conditions not be excluded from kidney transplantation but that patients be counseled on the risk of potential recurrent disease with its impact on transplant outcomes.

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Outcome of 313 Czech Patients With IgA Nephropathy After Renal Transplantation

Cited by 9 publications

References 41 publications

Risk factors for recurrent IgA nephropathy after renal transplantation: A meta-analysis

Risk factors for recurrent IgA nephropathy after renal transplantation: A meta-analysis

Evaluation of the Modified Oxford Score in Recurrent IgA Nephropathy in North American Kidney Transplant Recipients: The Banff Recurrent Glomerulonephritis Working Group Report

Kidney transplantation in pediatric patients with rheumatologic disorders

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