Different Recurrence Rates Between Pediatric and Adult Renal Transplant for Immunoglobulin A Nephropathy: Predictors of Posttransplant Recurrence.

OBJECTIVES The purpose of this study was to investigate immunoglobulin A nephropathy recurrence rate after transplant in children and adults and to identify recurrence rates by clinical progression before transplant. MATERIALS AND METHODS There were 56 patients with immunoglobulin A nephropathy who had renal transplant between 1989 and 2005. We categorized recipient age into < or ≥ 20 years at transplant. Each age category was divided into 2 levels based on recurrence. RESULTS The recurrence rate was higher in patients aged < 20 years(53.8%) than ≥ 20 years. Proteinuria was more frequently diagnosed in patients aged < 20 years (57.1% vs 25.0%; P = .047). In patients aged ≥ 20 years, the duration of dialysis was 4.55 months in the recurrence group and 17.78 months in the no recurrence group (P = .032). Time from progressive symptoms to renal replacement therapy was significantly shorter in patients aged ≥ 20 years with recurrence than patients aged ≥ 20 years with no recurrence. The univariate relative risk of recurrent immunoglobulin A nephropathy after transplant was 9.8 for recipients aged ≥ 20 years who had progressive symptoms to renal replacement therapy < 24 months (P = .046). CONCLUSIONS Patients aged < 20 years had more rapid disease progression to end-stage renal disease and a higher recurrence rate after transplant than patients aged ≥ 20 years. If patients aged ≥ 20 years progress rapidly from progressive symptoms to renal replacement therapy, renal transplant may be considered after 24 months because of high recurrence risk.