Clinical Characteristics and Long-term Outcome of Glomerulonephritis in Renal Allografts / 대한신장학회잡지
Korean Journal of Nephrology
;
: 603-610, 2005.
Artículo
en Coreano
| WPRIM
| ID: wpr-218834
ABSTRACT
BACKGROUND:
Since the introduction of cyclosporine, the short-term renal allograft survival has significantly improved. However, the long-term success is still limited by the development of chronic rejection and recurrent disease. Post-transplant glomerulonephritis (post-Tx GN) including recurrent disease is becoming an important cause of graft dysfunction.METHODS:
From November 1988 to June 2004, a total of 629 renal transplants involving 588 patients were performed at our medical center.RESULTS:
The prevalence rate of post-Tx GN was 11.9% in 629 renal transplant. Among 75 transplants diagnosed as post-Tx GN, IgA nephropathy (62.7%) was the most common histologic diagnosis, followed by focal segmental glomerulosclerosis (26.7 %), membranous glomerulonephritis (8.0%), membranoproliferative glomerulonephritis (1.3%) and diabetic nephropathy (1.3%). Documented histologic recurrence occurred in only 24.2% of patients with prior biopsy-proven glomerulonephritis of their native kidneys. The actuarial allograft survival at 5 and 10 years posttransplantation with post-Tx GN was 80.5 % and 27.9%, respectively; and the corresponding graft survival for patients without post-Tx GN was 74.9% and 52.3%, respectively (p<0.05). However, there was no significant difference in the graft survival according to type of post-Tx GN. The 5 and 10 year graft survival for patients with proteinuria over than 3.5 g/24 hr were 62.5% and 0%, which is significantly lower compared with 85.3% and 28.7% for patients with proteinuria less than 3.5 g/24 hr (p<0.01).CONCLUSION:
In conclusion, post-Tx GN is associated with decreased long-term graft survival and nephrotic range proteinuria is most important prognostic factor for graft survival. A prospective study with rigorous efforts to make pretransplant diagnosis and standardized criteria for allograft biopsy will more accurately characterize the natural history of post-Tx GN and may provide insight regarding treatment.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Proteinuria
/
Recurrencia
/
Biopsia
/
Glomeruloesclerosis Focal y Segmentaria
/
Glomerulonefritis Membranoproliferativa
/
Glomerulonefritis Membranosa
/
Prevalencia
/
Ciclosporina
/
Historia Natural
/
Trasplantes
Tipo de estudio:
Estudio diagnóstico
/
Estudio observacional
/
Estudio de prevalencia
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Coreano
Revista:
Korean Journal of Nephrology
Año:
2005
Tipo del documento:
Artículo
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