In:
American Journal of Nephrology, S. Karger AG, Vol. 51, No. 5 ( 2020), p. 357-365
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 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). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 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. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Eighty-six kidney transplants were performed in patients with IgAN, 38 (44%) were from living donors (related 〈 i 〉 n 〈 /i 〉 = 26). rIgAN was diagnosed in 23 allografts (27%). Renal function and proteinuria at the end of the follow-up period were worst in the rIgAN patients compared to those without rIgAN (2.2 vs. 1.4 mg/dL, 〈 i 〉 p 〈 /i 〉 = 0.014, and 1.16 vs. 0.49 g/day, 〈 i 〉 p 〈 /i 〉 = 0.005, respectively). Risk of rIgAN and progression to CKD 5 decreased with patient’s age (hazard ratio [HR] 0.95, 95% CI 0.92–0.98, 〈 i 〉 p 〈 /i 〉 = 0.002, and HR 0.97, 95% CI 0.83–0.97, 〈 i 〉 p 〈 /i 〉 = 0.008 per year, respectively). Patients with rIgAN had a higher risk of progression to CKD 5 (HR 6.7, 95% CI 1.3–35.7, 〈 i 〉 p 〈 /i 〉 = 0.025). Full donor-recipient mismatch in the human leukocyte antigen (HLA)-B loci decreased the risk of rIgAN (HR 0.22, 95% CI 0.06–0.76, 〈 i 〉 p 〈 /i 〉 = 0.017). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 rIgAN was an independent risk factor for ESRD after renal allograft. Younger age increased the risk of rIgAN and CKD 5. Conversely, HLA-B mismatching was a potential protective factor for rIgAN of this glomerular disease.
Type of Medium:
Online Resource
ISSN:
0250-8095
,
1421-9670
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1468523-1
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