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Abstract: SA-OR080

Outcomes of Kidney Transplantation in Primary Glomerulonephritis (GN) Mapped to Post-Transplant Proteinuria in the United Kingdom (UK) RaDaR Registry

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Gale, Daniel P., Royal Free Hospital, London, England, United Kingdom
  • Mercer, Alex, JAMCO Pharma Consulting, Stockholm, Sweden
  • Barratt, Jonathan, Leicester General Hospital, Leicester, England, United Kingdom
  • Kanigicherla, Durga Anil K., Manchester University NHS FT, Manchester, England, United Kingdom
  • Jones, Rachel B., Cambridge University NHS FT, Cambridge, England, United Kingdom
  • Oates, Thomas, Barts Health NHS Trust, London, England, United Kingdom
  • Salama, Alan D., UCL Centre Kidney Bladder Health, London, England, United Kingdom
  • Saleem, Moin A., University of Bristol, Bristol, England, United Kingdom
  • Shah, Sapna, King’s College Hospital, London, England, United Kingdom
  • Simms, Roslyn Jane, Sheffield Teaching Hospitals NHS FT, Sheffield, England, United Kingdom
  • Turner, A. Neil, University of Edinburgh, Edinburgh, Scotland, United Kingdom
  • Wong, Edwin Kwan Soon, Newcastle upon Tyne Hospitals NHS FT, Newcastle upon Tyne, England, United Kingdom
  • Hendry, Bruce M., Travere Therapeutics, Inc., San Diego, California, United States
  • Pitcher, David, UK Kidney Association, Bristol, England, United Kingdom
Background

Renal transplant outcomes vary by primary renal diagnosis and are influenced by the development of proteinuria post transplantation. This study quantifies these relationships using the transplant outcome data from 7 forms of GN and ADPKD in UK RaDaR.

Methods

RaDaR cohorts were identified with primary diagnoses of idiopathic nephrotic syndrome (INS), IgA Nephropathy (IgAN), ANCA nephritis, Membranoproliferative GN/C3 Glomerulopathy (MPGN), Alport Syndrome (AS), Anti-GBM disease and Membranous GN (PMN), with ADPKD as a non-GN comparator. 6172 patients were identified who had received a first renal transplant since 2005 and 34% of these had proteinuria data available sufficient to quantify UPCR at 1 year post-transplant. Table 1 shows key characteristics and demography at the time of transplantation and summary UPCR data at 1 year post transplant by diagnosis.

Results

Figure 1 shows outcomes of transplantation (survival without KF or eGFR <10) for the 8 groups; these vary by diagnosis with the highest rates of graft loss in the INS, MPGN and PMN groups. Figure 2 shows transplant survival for the total GN and ADPKD groups stratified by UPCR > or <0.5 g/g at one year post transplantation.

Conclusion

Transplant outcomes in GN vary by precise diagnosis and are generally worse than in ADPKD. Proteinuria at 1 year post transplantation is strongly correlated with long term outcomes; values above 0.5 g/g are more frequent in certain GN and are associated with over 60% graft failure within 10 years. The mechanisms underlying these findings are being assessed in ongoing work.

Funding

  • Commercial Support – Travere Therapeutics, Inc.

Digital Object Identifier (DOI)