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Recurrence of membranoproliferative glomerulonephritis type II in renal allografts: The North American Pediatric Renal Transplant Cooperative Study experience.
- Source :
-
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2005 Jul; Vol. 16 (7), pp. 2225-33. Date of Electronic Publication: 2005 May 11. - Publication Year :
- 2005
-
Abstract
- Membranoproliferative glomerulonephritis type II (MPGN II) is an uncommon form of complement-dependent acquired renal disease. Although it has been recognized since the 1970s that MPGN II recurs almost universally in renal transplants, data regarding the long-term consequences of disease recurrence are limited. Therefore, a retrospective comparative analysis of 75 patients with MPGN II contained in the North American Pediatric Renal Transplant Cooperative Study transplantation database was performed. Five-year graft survival for patients with MPGN II was significantly worse (50.0 +/- 7.5%) compared with the database as a whole (74.3 +/- 0.6%; P < 0.001). Living related donor organs had a significantly better 5-yr survival (65.9 +/- 10.7%) compared with cadaveric donor organs (34.1 +/- 9.8%; P = 0.004). The primary cause of graft failure in 11 (14.7%) patients was recurrent disease. Supplemental surveys were obtained on 29 (38%) of 75 patients. Analysis of these data indicated that recurrent disease occurred in 12 (67%) of the 18 patients with posttransplantation biopsies. Although there was no correlation between pretransplantation presentation, pre- or posttransplantation C3 levels, and either disease recurrence or graft failure, there was a strong association between heavy proteinuria and disease recurrence. The presence of glomerular crescents in allograft biopsies had a significant negative correlation with graft survival. At last follow-up, patients with recurrent disease had significantly higher serum creatinine and qualitatively more proteinuria than patients without biopsy-proven disease. These data indicate that recurrent MPGN II has a significant negative impact on renal allograft function and survival.
- Subjects :
- Child
Child, Preschool
Disease Progression
Female
Graft Survival
Humans
Infant
Infant, Newborn
Male
North America
Proteinuria etiology
Recurrence
Retrospective Studies
Transplantation, Homologous adverse effects
Glomerulonephritis, Membranoproliferative etiology
Glomerulonephritis, Membranoproliferative surgery
Kidney Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1046-6673
- Volume :
- 16
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Publication Type :
- Academic Journal
- Accession number :
- 15888559
- Full Text :
- https://doi.org/10.1681/ASN.2005020175