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

Exp Clin Transplant. 2015 Jun;13(3):227-32.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Disease Progression
  • Female
  • Glomerulonephritis, IGA / complications
  • Glomerulonephritis, IGA / diagnosis
  • Glomerulonephritis, IGA / surgery*
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult