Posttransplant recurrence of primary glomerulonephritis

Claudio Ponticelli, Richard J. Glassock

Research output: Contribution to journalArticle

Abstract

All forms of primary GN may recur after kidney transplantation and potentially jeopardize the survival of the graft. IgA nephritis (IgAN) may recur in approximately one third of patients, more frequently in younger patients and in those with a rapid progression of the original disease. However, with the exception of few patients with rapid progression, there is no evidence that recurrence of IgAN has a deleterious effect on graft survival at least up to 10 years. Recurrence of focal segmental glomerulosclerosis (FSGS) is often associated with nephrotic proteinuria and is more frequent in children, in patients with rapid progression of the original disease, and in those who lost a previous transplant from recurrence. The natural course of recurrent FSGS is usually unfavorable. Early and intensive plasmapheresis may obtain complete or partial response in several patients. Good results have also been reported with rituximab. Idiopathic membranous nephropathy (IMN) may recur in 30% to 40% of patients. The graft survival in patients with IMN is not different than that of patients with other renal diseases. Good results with rituximab have been reported. Membranoproliferative GN (MPGN) may recur in 27% to 65% of patients. The recurrence is more frequent and the prognosis is more severe in type II MPGN. Although recurrent GN is relatively frequent and may worsen the outcome of renal allografts in some patients, its effect is diluted by several other risk-factors that may have a greater effect than recurrent GN on the long-term graft survival.

Original languageEnglish
Pages (from-to)2363-2372
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number12
DOIs
Publication statusPublished - Dec 1 2010

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Glomerulonephritis
Recurrence
Graft Survival
Focal Segmental Glomerulosclerosis
Membranous Glomerulonephritis
Nephritis
Immunoglobulin A
Disease Progression
Kidney
Plasmapheresis
Proteinuria
Kidney Transplantation
Allografts
Transplants

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Posttransplant recurrence of primary glomerulonephritis. / Ponticelli, Claudio; Glassock, Richard J.

In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 12, 01.12.2010, p. 2363-2372.

Research output: Contribution to journalArticle

Ponticelli, Claudio ; Glassock, Richard J. / Posttransplant recurrence of primary glomerulonephritis. In: Clinical Journal of the American Society of Nephrology. 2010 ; Vol. 5, No. 12. pp. 2363-2372.
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