Kidney Res Clin Pract.
2012 Dec;31(4):219-226.
Incidence of post-transplant glomerulonephritis and its impact on graft outcome
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. cslimjy@snu.ac.kr
- 2Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
- 3Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
- 4Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
Abstract
- BACKGROUND
Herein, the significance of post-transplant glomerulonephritis (PTGN) has been revisited to investigate whether PTGN induces allograft failure. The aim of this study was to identify the incidence of PTGN and its association with allograft failure, as well as to analyze the risk factors for PTGN.
METHODS
Among the 996 Korean patients who underwent kidney transplantation in a multicenter cohort from 1995 to 2010, 764 patients were enrolled in this study.
RESULTS
The incidence rate of PTGN was 9.7% and 17.0% at 5 and 10 years of follow-up, respectively. PTGN was diagnosed in 17.8% of the recipients with results of biopsy tests or clinical diagnosis identifying glomerular diseases as the underlying cause, compared with 0.0%, 4.4%, 4.9%, 5.5%, and 5.7% of the recipients with renal vascular diseases, renal interstitial diseases/pyelonephritis/uropathy, diabetic renal disease, hereditary renal diseases, and diseases with unknown etiologies, respectively. Allograft survival was significantly decreased in patients with PTGN. PTGN was associated with a fourfold increase in graft failure with a hazard ratio of 7.11 for both acute rejection and PTGN. Results of the risk factor analysis for PTGN revealed that the underlying glomerular renal diseases and treatment methods using drugs such as tacrolimus and basiliximab significantly increased PTGN development, after adjusting for other risk factors.
CONCLUSION
We conclude that PTGN is strongly associated with poor kidney allograft survival. Therefore, optimal management of recurrent or de novo GN should be the critical focus of post-transplant care.
MeSH Terms
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Antibodies, Monoclonal
Biopsy
Cohort Studies
Follow-Up Studies
Genetic Diseases, Inborn
Glomerulonephritis
Graft Survival
Humans
Incidence
Kidney
Kidney Transplantation
Recombinant Fusion Proteins
Rejection (Psychology)
Risk Factors
Tacrolimus
Transplantation, Homologous
Transplants
Vascular Diseases
Antibodies, Monoclonal
Recombinant Fusion Proteins
Tacrolimus
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