Glomerulonephritis after kidney transplantation

B. Iványi, Dejan Dobi, Eva Kemeny, Edit Szederkenyi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The prevalence, impact and main clinicopathological aspects of recurrent and de novo glomerulonephritis are reviewed, with the use of unpublished data of the authors. The prevalence in Hungarian recipients was investigated in 697 biopsies obtained for cause and analyzed by light microscopy and an expanded panel of immunofluorescence. Electron microscopy was performed if there were symptoms of glomerular disease or the histological alterations or immunfluorescent findings indicated. Glomerular disease was recorded in 199 biopsies (28.5%): chronic rejection-induced transplant glomerulopathy in 155 biopsies (22.2%), post-transplantation glomerulonephritis (recurrent, de novo or undetermined) in 39 (5.5%) biopsies, and systemic disease affecting the glomeruli in 8 biopsies (1.1%).Membranous nephropathy (17), IgA nephritis (9), focal-segmental glomerulosclerosis (8), mesangial proliferative glomerulonephritis, (3) IgM nephropathy (1) and type I membranoproliferative glomerulonephritis (1) were identified. Transplant glomerulopathy frequently coincided with membranous nephropathy. Unusual combinations of histological patterns and/or immunofluorescent findings were occasionally observed, such as mesangial proliferation with mesangial and peripheral immune deposits, or epimembranous and mesangial deposits, or mesangial proliferation and subperimesangial deposits of solely IgM. Post-transplantation GN, more frequent in males, unfavorably influenced graft survival. Our results and the literature data indicate that posttransplantation glomerulonephritis relatively rarely involves the white race. Male gender, non-white ethnicity, younger age and biopsy-proven glomerulonephritis in the native kidney are predictors of posttransplantation glomerulonephritis. Post-transplantation glomerulonephritis contributes significantly to late allograft loss; through elevated serum creatinine levels and proteinuria, it precipitates the cardiovascular mortality and morbidity of the recipient. Limited evidence is available on the management of post-transplantation glomerulonephritis.

Original languageEnglish
Title of host publicationKidney Transplantation: Challenging the Future
PublisherBentham Science Publishers Ltd.
Pages324-339
Number of pages16
ISBN (Print)9781608054244
DOIs
Publication statusPublished - 2012

Fingerprint

Glomerulonephritis
Kidney Transplantation
Biopsy
Transplantation
Membranous Glomerulonephritis
Immunoglobulin M
Membranoproliferative Glomerulonephritis
Focal Segmental Glomerulosclerosis
Nephritis
Graft Rejection
Graft Survival
Proteinuria
Immunoglobulin A
Fluorescent Antibody Technique
Allografts
Microscopy
Creatinine
Electron Microscopy
Morbidity
Transplants

Keywords

  • De novo glomerulonephritis
  • Epidemiology
  • Immunosuppression
  • Kidney biopsy
  • Kidney transplant
  • Membranous nephropathy.
  • Plasmapheresis
  • Recurrent glomerulonephritis
  • Rituximab
  • Steroids

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Iványi, B., Dobi, D., Kemeny, E., & Szederkenyi, E. (2012). Glomerulonephritis after kidney transplantation. In Kidney Transplantation: Challenging the Future (pp. 324-339). Bentham Science Publishers Ltd.. https://doi.org/10.2174/978160805144111201010324

Glomerulonephritis after kidney transplantation. / Iványi, B.; Dobi, Dejan; Kemeny, Eva; Szederkenyi, Edit.

Kidney Transplantation: Challenging the Future. Bentham Science Publishers Ltd., 2012. p. 324-339.

Research output: Chapter in Book/Report/Conference proceedingChapter

Iványi, B, Dobi, D, Kemeny, E & Szederkenyi, E 2012, Glomerulonephritis after kidney transplantation. in Kidney Transplantation: Challenging the Future. Bentham Science Publishers Ltd., pp. 324-339. https://doi.org/10.2174/978160805144111201010324
Iványi B, Dobi D, Kemeny E, Szederkenyi E. Glomerulonephritis after kidney transplantation. In Kidney Transplantation: Challenging the Future. Bentham Science Publishers Ltd. 2012. p. 324-339 https://doi.org/10.2174/978160805144111201010324
Iványi, B. ; Dobi, Dejan ; Kemeny, Eva ; Szederkenyi, Edit. / Glomerulonephritis after kidney transplantation. Kidney Transplantation: Challenging the Future. Bentham Science Publishers Ltd., 2012. pp. 324-339
@inbook{fef33a4ea3fb4184a67237da0fcbd05b,
title = "Glomerulonephritis after kidney transplantation",
abstract = "The prevalence, impact and main clinicopathological aspects of recurrent and de novo glomerulonephritis are reviewed, with the use of unpublished data of the authors. The prevalence in Hungarian recipients was investigated in 697 biopsies obtained for cause and analyzed by light microscopy and an expanded panel of immunofluorescence. Electron microscopy was performed if there were symptoms of glomerular disease or the histological alterations or immunfluorescent findings indicated. Glomerular disease was recorded in 199 biopsies (28.5{\%}): chronic rejection-induced transplant glomerulopathy in 155 biopsies (22.2{\%}), post-transplantation glomerulonephritis (recurrent, de novo or undetermined) in 39 (5.5{\%}) biopsies, and systemic disease affecting the glomeruli in 8 biopsies (1.1{\%}).Membranous nephropathy (17), IgA nephritis (9), focal-segmental glomerulosclerosis (8), mesangial proliferative glomerulonephritis, (3) IgM nephropathy (1) and type I membranoproliferative glomerulonephritis (1) were identified. Transplant glomerulopathy frequently coincided with membranous nephropathy. Unusual combinations of histological patterns and/or immunofluorescent findings were occasionally observed, such as mesangial proliferation with mesangial and peripheral immune deposits, or epimembranous and mesangial deposits, or mesangial proliferation and subperimesangial deposits of solely IgM. Post-transplantation GN, more frequent in males, unfavorably influenced graft survival. Our results and the literature data indicate that posttransplantation glomerulonephritis relatively rarely involves the white race. Male gender, non-white ethnicity, younger age and biopsy-proven glomerulonephritis in the native kidney are predictors of posttransplantation glomerulonephritis. Post-transplantation glomerulonephritis contributes significantly to late allograft loss; through elevated serum creatinine levels and proteinuria, it precipitates the cardiovascular mortality and morbidity of the recipient. Limited evidence is available on the management of post-transplantation glomerulonephritis.",
keywords = "De novo glomerulonephritis, Epidemiology, Immunosuppression, Kidney biopsy, Kidney transplant, Membranous nephropathy., Plasmapheresis, Recurrent glomerulonephritis, Rituximab, Steroids",
author = "B. Iv{\'a}nyi and Dejan Dobi and Eva Kemeny and Edit Szederkenyi",
year = "2012",
doi = "10.2174/978160805144111201010324",
language = "English",
isbn = "9781608054244",
pages = "324--339",
booktitle = "Kidney Transplantation: Challenging the Future",
publisher = "Bentham Science Publishers Ltd.",

}

TY - CHAP

T1 - Glomerulonephritis after kidney transplantation

AU - Iványi, B.

AU - Dobi, Dejan

AU - Kemeny, Eva

AU - Szederkenyi, Edit

PY - 2012

Y1 - 2012

N2 - The prevalence, impact and main clinicopathological aspects of recurrent and de novo glomerulonephritis are reviewed, with the use of unpublished data of the authors. The prevalence in Hungarian recipients was investigated in 697 biopsies obtained for cause and analyzed by light microscopy and an expanded panel of immunofluorescence. Electron microscopy was performed if there were symptoms of glomerular disease or the histological alterations or immunfluorescent findings indicated. Glomerular disease was recorded in 199 biopsies (28.5%): chronic rejection-induced transplant glomerulopathy in 155 biopsies (22.2%), post-transplantation glomerulonephritis (recurrent, de novo or undetermined) in 39 (5.5%) biopsies, and systemic disease affecting the glomeruli in 8 biopsies (1.1%).Membranous nephropathy (17), IgA nephritis (9), focal-segmental glomerulosclerosis (8), mesangial proliferative glomerulonephritis, (3) IgM nephropathy (1) and type I membranoproliferative glomerulonephritis (1) were identified. Transplant glomerulopathy frequently coincided with membranous nephropathy. Unusual combinations of histological patterns and/or immunofluorescent findings were occasionally observed, such as mesangial proliferation with mesangial and peripheral immune deposits, or epimembranous and mesangial deposits, or mesangial proliferation and subperimesangial deposits of solely IgM. Post-transplantation GN, more frequent in males, unfavorably influenced graft survival. Our results and the literature data indicate that posttransplantation glomerulonephritis relatively rarely involves the white race. Male gender, non-white ethnicity, younger age and biopsy-proven glomerulonephritis in the native kidney are predictors of posttransplantation glomerulonephritis. Post-transplantation glomerulonephritis contributes significantly to late allograft loss; through elevated serum creatinine levels and proteinuria, it precipitates the cardiovascular mortality and morbidity of the recipient. Limited evidence is available on the management of post-transplantation glomerulonephritis.

AB - The prevalence, impact and main clinicopathological aspects of recurrent and de novo glomerulonephritis are reviewed, with the use of unpublished data of the authors. The prevalence in Hungarian recipients was investigated in 697 biopsies obtained for cause and analyzed by light microscopy and an expanded panel of immunofluorescence. Electron microscopy was performed if there were symptoms of glomerular disease or the histological alterations or immunfluorescent findings indicated. Glomerular disease was recorded in 199 biopsies (28.5%): chronic rejection-induced transplant glomerulopathy in 155 biopsies (22.2%), post-transplantation glomerulonephritis (recurrent, de novo or undetermined) in 39 (5.5%) biopsies, and systemic disease affecting the glomeruli in 8 biopsies (1.1%).Membranous nephropathy (17), IgA nephritis (9), focal-segmental glomerulosclerosis (8), mesangial proliferative glomerulonephritis, (3) IgM nephropathy (1) and type I membranoproliferative glomerulonephritis (1) were identified. Transplant glomerulopathy frequently coincided with membranous nephropathy. Unusual combinations of histological patterns and/or immunofluorescent findings were occasionally observed, such as mesangial proliferation with mesangial and peripheral immune deposits, or epimembranous and mesangial deposits, or mesangial proliferation and subperimesangial deposits of solely IgM. Post-transplantation GN, more frequent in males, unfavorably influenced graft survival. Our results and the literature data indicate that posttransplantation glomerulonephritis relatively rarely involves the white race. Male gender, non-white ethnicity, younger age and biopsy-proven glomerulonephritis in the native kidney are predictors of posttransplantation glomerulonephritis. Post-transplantation glomerulonephritis contributes significantly to late allograft loss; through elevated serum creatinine levels and proteinuria, it precipitates the cardiovascular mortality and morbidity of the recipient. Limited evidence is available on the management of post-transplantation glomerulonephritis.

KW - De novo glomerulonephritis

KW - Epidemiology

KW - Immunosuppression

KW - Kidney biopsy

KW - Kidney transplant

KW - Membranous nephropathy.

KW - Plasmapheresis

KW - Recurrent glomerulonephritis

KW - Rituximab

KW - Steroids

UR - http://www.scopus.com/inward/record.url?scp=84882796534&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84882796534&partnerID=8YFLogxK

U2 - 10.2174/978160805144111201010324

DO - 10.2174/978160805144111201010324

M3 - Chapter

SN - 9781608054244

SP - 324

EP - 339

BT - Kidney Transplantation: Challenging the Future

PB - Bentham Science Publishers Ltd.

ER -