Recurrence of IgA Nephropathy With Crescents in Kidney Transplants

Mousson, C.; Charon-Barra, Céline; Vega, Mathilde Funes de la; Tanter, Y.; Justrabo, E; Martin, Laurent; Rifle, G

doi:10.1016/j.transproceed.2007.08.025

Cited by 14 publications

(11 citation statements)

References 8 publications

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“…To our knowledge, this is the first investigation of DGFR in the native kidneys as a risk factor of graft loss in transplanted patients with IgAN. The findings in the present study are supported by casuistic reports of patients with an aggressive pre-transplant course of IgAN with crescents followed by recurrence after transplantation and subsequent graft loss (22)(23)(24). In a Swedish study, the time between diagnosis of IgAN and ESRD was significantly shorter in patients who experienced recurrence of IgAN in their grafts (14).…”

Section: Discussionsupporting

confidence: 88%

“…A higher recurrence rate among patients with IgAN transplanted with an LRD graft could explain this unexpected finding (21). In spite of few studies, there are some indications that an aggressive presentation and course of IgAN in native kidneys may represent an increased risk of recurrence (14, 22–24) and possibly also graft loss after transplantation.…”

mentioning

confidence: 99%

“…few studies, there are some indications that an aggressive presentation and course of IgAN in native kidneys may represent an increased risk of recurrence (14,(22)(23)(24) and possibly also graft loss after transplantation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

Bjørneklett

Vikse

Smerud

et al. 2011

Clinical Transplantation

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

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

Bjørneklett

Vikse

Smerud

et al. 2011

Clinical Transplantation

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“…Accumulating data suggest that the renal survival in cases of crescentic IgAN is only 50% at one year, and 20% at five years (12). On the other hand, according to one report, patients with >25% crescents at the initial biopsy showed a -50% renal survival after four years (13). These reports showed that patients with the RPGN type or crescentic glomerulonephritis showed significantly worse outcomes than those without.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Pathological Studies of IgA Nephropathy Presenting as a Rapidly Progressive Form of Glomerulonephritis

et al. 2013

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Objective IgA nephropathy (IgAN) is widely regarded as a slowly progressive disease. However, a minor population of patients present with a rapidly progressive form of glomerulonephritis (RPGN). Methods We studied 25 cases of IgAN who presented with RPGN. The laboratory data, histology, and five-year prognosis after diagnostic renal biopsy were evaluated. We compared the data of these patients with those of 495 patients with the non-RPGN type. In addition, we divided the patients with the RPGN type of IgAN into a group with reduced renal function and a group with maintained renal function, and compared the data between the two groups. Results In the 'RPGN type', the serum creatinine levels and a 24-hour urinary protein excretion were significantly higher than in the non-RPGN type. Histological examinations showed that the rates of endocapillary hypercellularity and tubular atrophy/interstitial fibrosis were significantly higher in the patients with the RPGN type. In the comparison between the groups with reduced and maintained renal functions, the former group exhibited higher levels of proteinuria, serum creatinine and crescent formation than the latter group. Conclusion The RPGN type of IgAN was significantly worse in terms of the renal survival rate at five years than the non-RPGN type. Intensive and active treatments are necessary for this minor population, according to the guideline for the management of RPGN.

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“…Most often post-txp IgAN is an incidental finding with no serious clinical consequences, but crescentic features have been associated with poor graft outcome. 12,13 This can lead to graft failure as seen in our patient despite aggressive therapy.…”

Section: Discussionmentioning

confidence: 73%

Immune‐mediated nephropathies in kidney transplants: recurrent or de novo diseases

Roberti¹,

Vyas²

2016

Pediatric Transplantation

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IMN contribute to ESRD in 13% children with renal transplant (txp). Recurrent or de novo IMN can cause graft dysfunction and/or failure, but the details regarding incidence, therapy, and outcome remain poorly understood. Retrospective single-center study of all pediatric kidney txp was carried out since 1998. Clinical presentation, pathology, therapy, and graft outcomes of children with recurrent or de novo IMN were reviewed. IMN was the primary etiology of ESRD in 28 of the 149 txp recipients. Eleven children had biopsy-proven post-txp IMN-six were recurrent and five had de novo. Presentation varied with changes in SCr and/or proteinuria. Initial therapy included higher doses of steroids, MMF, and tacrolimus. Outcome was excellent with only one late graft loss. Full remission was achieved in all other patients, but some had re-recurrence of the IMN. Median follow-up time was 11.8 years. IMN (recurrent or de novo) occurred in 7.4% (11 of 149) of all kidney txp performed at our center. IMN post-txp was often seen late post-txp, usually asymptomatic and noted to have relapsing pattern. Early diagnosis and prompt therapy resulted in excellent long-term outcome in children diagnosed with post-txp IMN.

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Recurrence of IgA Nephropathy With Crescents in Kidney Transplants

Cited by 14 publications

References 8 publications

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

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

Clinical and Pathological Studies of IgA Nephropathy Presenting as a Rapidly Progressive Form of Glomerulonephritis

Immune‐mediated nephropathies in kidney transplants: recurrent or de novo diseases

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