TY - JOUR
T1 - Recurrence of iga nephropathy after kidney transplantation in adults
AU - Uffing, Audrey
AU - Pérez-Saéz, Maria José
AU - Jouve, Thomas
AU - Bugnazet, Mathilde
AU - Malvezzi, Paolo
AU - Muhsin, Saif A.
AU - Lafargue, Marie Camille
AU - Reindl-Schwaighofer, Roman
AU - Morlock, Alina
AU - Oberbauer, Rainer
AU - Buxeda, Anna
AU - Burballa, Carla
AU - Pascual, Julio
AU - Von Moos, Seraina
AU - Seeger, Harald
AU - La Manna, Gaetano
AU - Comai, Giorgia
AU - Bini, Claudia
AU - Russo, Luis Sanchez
AU - Farouk, Samira
AU - Nissaisorakarn, Pitchaphon
AU - Patel, Het
AU - Agrawal, Nikhil
AU - Mastroianni-Kirsztajn, Gianna
AU - Mansur, Juliana
AU - Tedesco-Silva, Hélio
AU - Venturaé, Carlucci Gualberto
AU - Agena, Fabiana
AU - David-Neto, Elias
AU - Akalin, Enver
AU - Alani, Omar
AU - Mazzali, Marilda
AU - Manfro, Roberto Ceratti
AU - Bauer, Andrea Carla
AU - Wang, Aileen X.
AU - Cheng, Xingxing S.
AU - Schold, Jesse D.
AU - Berger, Stefan P.
AU - Cravedi, Paolo
AU - Riella, Leonardo V.
N1 - Publisher Copyright:
© 2021 by the American Society of Nephrology.
PY - 2021/8
Y1 - 2021/8
N2 - Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small. Design, setting, participants, & measurementsWe performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 “The Post-Transplant Glomerular Disease” study centers in Europe, North America, and South America. Results Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donorspecific antibodies (hazardratio, 2.59; 95%confidence interval, 1.09 to 6.19).Afterkidneytransplantation,development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence. Conclusions In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.
AB - Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small. Design, setting, participants, & measurementsWe performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 “The Post-Transplant Glomerular Disease” study centers in Europe, North America, and South America. Results Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donorspecific antibodies (hazardratio, 2.59; 95%confidence interval, 1.09 to 6.19).Afterkidneytransplantation,development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence. Conclusions In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.
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U2 - 10.2215/CJN.00910121
DO - 10.2215/CJN.00910121
M3 - Article
C2 - 34362788
AN - SCOPUS:85114029157
SN - 1555-9041
VL - 16
SP - 1247
EP - 1255
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 8
ER -