Pre‐transplant course and risk of kidney transplant failure in IgA nephropathy patients

Bjørneklett, Rune; Vikse, Bjørn Egil; Smerud, Hilde Kloster; Bostad, Leif; Leivestad, Torbjørn; Hartmann, Anders; Iversen, Bjarne M.

doi:10.1111/j.1399-0012.2011.01424.x

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…It has been suggested that those recipients with a severe and rapidly progressive course in the native kidney have a higher risk of a rIgAN after transplantation, with clinical impact on graft survival. A rapid loss of renal function, defined as DGFR > 30 mL/min/1.73 m 2 per year, between diagnosis of IgAN and initiation of RRT was a strong predictor of graft loss after kidney transplantation [6]. These previous observations are in agreement with the finding of an exponentially decreasing relation between age at transplantation and risk of rIgAN reported in this study.…”

Section: Pretransplant Serum Gd-iga1 Levelssupporting

confidence: 92%

IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch

et al. 2020

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Background: 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). Methods: 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. Results: Eighty-six kidney transplants were Developing a Risk Score of IgAN Recurrence 359 Am

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Section: Pretransplant Serum Gd-iga1 Levelssupporting

confidence: 92%

IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch

et al. 2020

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“…Annualized loss of eGFR may have been a more meaningful measure of pre-transplant disease activity 20 , however creatinine at time of biopsy was not consistently documented. Post-transplantation data included allograft type (living vs. deceased donor), induction and maintenance immunosuppression, biopsy proven allograft rejection and grade, BK viremia and/or nephropathy, occurrence of proteinuria, nephrotic syndrome (defined as proteinuria > 3.5g per gram of creatinine, hypoalbuminemia, and clinical documentation), hypertension (defined as BP > 140/90 mmHg or need for antihypertensives to achieve a BP of < 140/90mmHg), graft loss (defined as return to dialysis or re-transplantation) and mortality.…”

Section: Methodsmentioning

confidence: 97%

Predicting Post-Transplant Recurrence of IgA Nephropathy: The Importance of Crescents

Avasare¹,

Rosenstiel

Zaky

et al. 2017

Am J Nephrol

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Background: Most studies that have assessed the predictors of recurrent IgA nephropathy (IgAN) in the renal allograft have focused on post-transplant features. Identifying high-risk pre-transplant features of IgAN is useful for counseling patients and may help in tailoring post-transplant immunosuppression. Methods: We investigated the pre-transplant clinical and biopsy features of 62 patients with IgAN who received transplants at Columbia University Medical Center from 2001 to 2012 and compared the characteristics and outcomes of patients with IgAN recurrence to those without recurrence. The primary outcome was time to recurrent IgAN. Secondary outcomes were a composite of doubling of creatinine or allograft failure, and recurrent IgAN as a cause of allograft dysfunction. Results: Of the 62 patients, 14 had recurrent IgAN in the allograft. Mean time to recurrence was 2.75 years. Those with recurrent disease were younger at the time of native kidney biopsy (29 vs. 41 years, p < 0.0009). Black race and Hispanic ethnicity composed a higher proportion of the recurrent disease group. On multivariable analysis, significant predictors of recurrent IgAN included age at diagnosis (hazards ratio (HR) 0.911, 95% CI 0.85-0.98), burden of crescents on native biopsy (HR 1.21 per 10% increase in crescents, 95% CI 1.00-1.47) and allograft rejection (HR 3.59, 95% CI 1.10-11.7). Conclusions: Features of native IgAN can help predict the risk of recurrent disease in the renal allograft. In particular, immunologically active disease represented by earlier age of onset and greater burden of crescents on native biopsy is more likely to recur after transplant.

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“…Recurrence in the allograft is more common in children than in adults 79 and is associated with crescentic disease and a rapid decline in renal function before engraftment. 81 In most transplantation centers, recurrent disease is not more frequent in kidneys from living related donors than in those from deceased donors, although the possibility of familial disease or covert IgA nephropathy mandates careful evaluation before nephrectomy. Whether the circulating level of galactose-deficient IgA1 or anti-glycan antibodies influences the post-transplantation course remains unknown.…”

Section: Pathological Prognostic Markersmentioning

confidence: 99%

IgA Nephropathy

2013

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Pre‐transplant course and risk of kidney transplant failure in IgA nephropathy patients

Abstract: A rapid pre-transplant course is a strong risk factor for transplant failure in patients with IgAN.

Cited by 8 publications

References 20 publications

IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch

IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch

Predicting Post-Transplant Recurrence of IgA Nephropathy: The Importance of Crescents

IgA Nephropathy

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