Recurrent glomerulonephritis after renal transplantation: an unsolved problem.
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES Despite advances in prevention of acute rejection and improved short- and long-term kidney graft survival, recurrent glomerulonephritis remains problematic and poorly characterized. This study analyzed prevalence and outcome of recurrent glomerulonephritis from various registries. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Definition, classification, and limitations in evaluating epidemiology of native and recurrent glomerulonephritis are discussed. Epidemiology of native glomerulonephritis as the cause of end-stage renal failure and subsequent recurrence of individual glomerulonephritis was evaluated using data from various registries, and pathogenesis of individual glomerulonephritis is discussed. RESULTS Analysis of data from transplant registries revealed that glomerulonephritis is an important cause of end-stage renal disease in white and pediatric recipients; however, glomerulonephritis as the cause of end-stage renal disease is not characterized well in black recipients, and many of them are perhaps labeled to have hypertensive nephrosclerosis as the cause of renal disease without renal biopsy. A systematic approach toward urinalysis after transplantation and utility of immunofluorescence and electron microscopic examination of renal biopsy tissues will identify the true prevalence of recurrent glomerulonephritis. Data on recurrent glomerulonephritis should be compiled by either using registry analysis or pooling data from multiple centers. This will provide true data on prevalence and outcome and could potentially initiate translational research studies. CONCLUSIONS The understanding of the pathogenesis of recurrent glomerulonephritis is critical to optimize prevention as well as to treat individual recurrent glomerulonephritis, which can enhance long-term graft survival.
منابع مشابه
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1. Briganti EM, Russ GR, McNeil JJ et al. Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med 2002; 347: 103–109 2. Odum J, Peh CA, Clarkson AR et al. Recurrent mesangial IgA nephritis following renal transplantation. Nephrol Dial Transplant 1994; 9: 309–312 3. Ortiz F, Gelpi R, Koskinen P et al. IgA nephropathy recurs early in the graft when assessed by protocol biopsy...
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ورودعنوان ژورنال:
- Clinical journal of the American Society of Nephrology : CJASN
دوره 3 3 شماره
صفحات -
تاریخ انتشار 2008