Abstract: PO2158
Glomerulonephritis After Kidney Transplantation: Prevalence, Clinical Characteristics, and Outcomes
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Martinez-Vazquez, Belen, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
- Garcia-Flores, Octavio Rene, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
- Flores Gama, Cesar, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
Background
The Glomerulonephritis after kidney transplantation (GNKT) is an unknown disease, being the third cause of kidney allograft loss. It is defined as the development of glomerulonephritis (GN) in the allograft and is classified in: recurrent, novo and with unknown primary disease. The prevalence varies to 2-12%, the majority report figures to 6-8%. Recurrent GN have a higher risk of kidney allograft failure (KAF), the most frequent reported are IgAN (9.7%), FSGS (12.7%), MPGN (14.4%) and MN (12.5%).
Methods
We conducted a single-center, retrospective cohort study during 10 years in a tertiary hospital in Mexico City. We included 50 patients with biopsy-proven GN in the kidney allograft. We examined the relationship between clinical, biochemical and histologic parameters to predict the KAF in GNKT. We used age and sex adjusted Cox proportional hazards models.
Results
50 patients were included, median age 39 years, 50% were female, mean creatinine and proteinuria at biopsy were 2.6± 3.0 mg/dL and 2.8± 2.9 g/day respectively. The main biopsy indications was allograft dysfunction in 46%. The mean follow-up was 41.7±33.1 months. KAF occurred in 18 patients (36%). Of the total cases 7 corresponded to recurrent GN and 5 cases to de novo GN. The main etiologies were IgAN 12 (24%), MN 10(20%), DKD 9 (18%) and PGN 5 (10%). 12 patients had acute rejection and was not associated with kidney allograft loss (p= 0.06).
Conclusion
In the present study we found that the incidence of GNKT is similar to that reported in other series, with primary GN being the ones with the highest incidence, in our series IgAN was the most frequent. There were 7 cases of recurrent GN and only 5 cases of de novo GN, the rest GNKT with unknown primary disease. It is noteworthy that in our series we identified 5 cases of ANCA-associated vasculitis. The KAF was 36%, similar to that reported in the literature and MN was the main etiology.