Renal transplant outcomes in patients with autosomal dominant tubulointerstitial kidney disease

Abstract

Introduction Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a rare genetic cause of chronic kidney disease (CKD) and end‐stage renal disease (ESRD). We aimed to compare renal transplant outcomes in people with ESRD due to ADTKD to those with other causes of renal failure. Methods Patients with clinical characteristics consistent with ADTKD by the criteria outlined in the 2015 KDIGO consensus were included. We compared ADTKD transplant outcomes with those of 4633 non‐ADTKD renal transplant recipients. Results We included 31 patients who met diagnostic criteria for ADTKD in this analysis, 23 of whom had an identified mutation (28 were categorized as definite‐ADTKD and 3 as suspected ADTKD). Five patients received a second transplant during follow‐up. In total, 36 grafts were included. We did not identify significant differences between groups in terms of graft or patient survival after transplantation. Twenty‐five transplant biopsies were performed during follow‐up, and none of these showed signs of recurrent ADTKD post‐transplant. Conclusion In patients with ESRD due to ADTKD, we demonstrate that transplant outcomes are comparable with the general transplant population. There is no evidence that ADTKD can recur after transplantation.

Autosomal Dominant Tubulointerstitial Kidney Disease–UMOD: A Monogenic Renal Disease that Cannot Be Ignored

“…Patients with ESRD caused by ADTKD-UMOD are considered suitable candidates for kidney transplantation because the transplanted kidney is not at risk of disease recurrence. [65] It is recommended that unaffected family members undergo genetic testing to determine their eligibility to be living kidney donors.…”

UMOD and you! Explaining a rare disease diagnosis

“…Salt-wasting symptoms are typically ‘polyuria’ (passing large volumes or urine frequently or bed-wetting at night) and ‘polydipsia’ (excessive thirst) and occur early in the disease [ 9 ]. ADTKD does not recur after kidney transplantation [ 10 ].…”

Clinical and genetic spectra of autosomal dominant tubulointerstitial kidney disease

“…Diuretics should be used with caution, as they might lead to symptomatic volume contraction [ 25 ]. In patients with ESKD, transplantation is the preferred therapeutic option, with outcomes that are comparable with the general transplant population and no evidence of disease recurrence [ 38 ]. In line with early involvement of inflammatory pathways, in vivo tumour necrosis factor α blockade slowed disease progression in a mouse model of ADTKD- UMOD [ 20 ].…”