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  • Title: IgA NEPHROPATHY IN PATIENTS RECEIVING A RENAL TRANSPLANT.
    Author: Lemes-Canuto AP, de Sandes-Freitas TV, Medina-Pestana JO, Mastroianni-Kirsztajn G.
    Journal: J Ren Care; 2015 Dec; 41(4):222-30. PubMed ID: 25819382.
    Abstract:
    BACKGROUND: IgA nephropathy (IgAN) is the third most frequent cause of renal graft loss among patients with primary glomerulonephritis. OBJECTIVES: To assess clinical and laboratorial profile of patients with pre and/or post transplant IgAN, in addition to patient and graft survival in both groups. DESIGN: Data from 146 patients who had received a renal transplant were retrospectively collected and were divided in two groups: group 1-patients with biopsy-documented IgAN as the underlying native kidney disease (n = 128); group 2-patients who developed post-transplant IgAN independent of the underlying disease (n = 18). PARTICIPANTS: Patients submitted to renal transplantation (1998-2010) with pre and/or post transplant IgAN. MEASUREMENTS: Clinical and laboratorial evaluation of renal function of 146 post transplant IgAN patients. RESULTS: Recipients and deceased donors exhibited a higher degree of HLA compatibility (1.0 vs. 2.5 mismatches for groups 1 and 2, respectively). The main post-transplant IgAN presentation was haematuria associated with non-nephrotic proteinuria (44.4%). A histological pattern of focal segmental glomerulosclerosis was observed in 59.2% of biopsy samples. The 10-year patient survival was 93.5% in group 1 and 100% in group 2, and the graft survival rates were 58.5 and 87.2%, respectively. CONCLUSION: The rate of post-transplant IgA diagnosis in our case series was 11%, and IgAN was diagnosed late in the course of transplantation. In most cases, IgAN manifested as haematuria and non-nephrotic proteinuria, without renal graft dysfunction, and this picture might explain late indication of graft biopsies. The 10-year patient survival rates were excellent.
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