ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Acute Kidney Injury/therapy , Hypoalbuminemia/prevention & control , Immunoglobulin kappa-Chains/analysis , Kidney Tubules/chemistry , Membranes, Artificial , Multiple Myeloma/complications , Myeloma Proteins/analysis , Renal Dialysis/methods , Acute Kidney Injury/blood , Acute Kidney Injury/etiology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bortezomib/administration & dosage , Dexamethasone/administration & dosage , Immunoglobulin kappa-Chains/blood , Kidneys, Artificial , Multiple Myeloma/blood , Multiple Myeloma/diagnosis , Multiple Myeloma/drug therapy , Renal Dialysis/instrumentation , Serum Albumin/analysisABSTRACT
IgA nephropathy (IgAN) recurrence in the renal graft is variable. Several factors can influence the risk of recurrence of IgAN and renal graft failure. We carried out a retrospective observational study between the years 1990 and 2018. The study group was patients diagnosed, by means of biopsy, as having post-renal transplant (RT) IgAN in our hospital in the study period. The control group was patients with pre-RT histologic diagnosis of IgAN who did not develop recurrence of the disease after the RT. A total of 1535 RTs were performed in our center in the study period. Of those, 24 patients developed IgAN in the renal graft. The time elapsed from the RT to the development of allograft IgAN was 7 (SD, 5.3) years. The patients with allograft IgAN tended to be younger (P = .069), and HLA-DR4 was more common in these patients (P = .078). We observed a very significant difference in the use of induction immunosuppressive therapy (study group vs control group: 13.6% vs 57.7%, P < .001). The 3 patients who presented crescents in the biopsy specimen lost the renal graft. As in the native kidney, the presence of crescents is an indicator of poor prognosis. In our experience, the patients with post-RT IgAN received induction therapy less frequently; this finding would support the conclusion that such treatments should be applied to patients with pre-RT diagnosis of IgAN.
Subject(s)
Glomerulonephritis, IGA/immunology , Immunosuppression Therapy/adverse effects , Kidney Transplantation/adverse effects , Postoperative Complications/immunology , Adult , Allografts/immunology , Allografts/pathology , Biopsy , Female , Graft Survival , Humans , Immunosuppression Therapy/methods , Immunosuppressive Agents/adverse effects , Kidney/immunology , Kidney/pathology , Male , Middle Aged , Recurrence , Retrospective StudiesSubject(s)
Acute Kidney Injury/therapy , Hypoalbuminemia/prevention & control , Immunoglobulin kappa-Chains/analysis , Kidney Tubules/chemistry , Membranes, Artificial , Multiple Myeloma/complications , Myeloma Proteins/analysis , Renal Dialysis/methods , Acute Kidney Injury/blood , Acute Kidney Injury/etiology , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bortezomib/administration & dosage , Dexamethasone/administration & dosage , Female , Humans , Immunoglobulin kappa-Chains/blood , Kidneys, Artificial , Male , Middle Aged , Multiple Myeloma/blood , Multiple Myeloma/diagnosis , Multiple Myeloma/drug therapy , Renal Dialysis/instrumentation , Serum Albumin/analysisABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Antibodies, Monoclonal, Humanized/administration & dosage , Atypical Hemolytic Uremic Syndrome/drug therapy , Complement Inactivating Agents/administration & dosage , Time FactorsABSTRACT
BACKGROUND: Chronic graft nephropathy is the most frequent cause of long-term renal transplant loss. Although immunological causes participate in its pathogenesis, other non-immunological factors such as hyperfiltration due to reduced renal mass have been proposed as causal factors of chronic renal graft nephropathy. AIM: This study aimed to assess the effect of weight disproportion between the donor and recipient in the development of chronic renal graft nephropathy. METHODS: Three weight categories for donors and recipients were established: < 50, 50-75 and > 75 kg. Three groups were distinguished according to the three possible weight combinations between donor and recipient: donor weight (DW)>recipient weight (RW) (N = 133), DW = RW (N = 255) and DWSubject(s)
Body Weight
, Kidney Diseases/etiology
, Kidney Transplantation/adverse effects
, Tissue Donors
, Adult
, Chronic Disease
, Female
, Graft Survival
, Humans
, Kidney Transplantation/mortality
, Male
, Matched-Pair Analysis
, Middle Aged
, Survival Rate
, Time Factors