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J Postgrad Med. 2007 Apr-Jun;53(2):92-5.

Outcomes of renal transplantation in patients with immunoglobulin A nephropathy in India.

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1
Department of Nephrology, Christian Medical College, Vellore-632 004, India.

Abstract

BACKGROUND:

There is a paucity of data on the course of renal transplant in patients with immunoglobulin A (IgA) nephropathy (IgAN) from India. While the natural history of IgAN in the Indian context is rapidly progressive, the post-transplant course remains speculative.

AIM:

To study the graft survival in renal transplant recipients whose native kidney disease was IgAN and the incidence and correlates of recurrent disease.

SETTINGS AND DESIGNS:

Retrospective case control study from a Nephrology unit of a large tertiary care center.

MATERIALS AND METHODS:

The outcomes of 56 transplant patients (58 grafts) with biopsy-proven IgAN and of 116 patients without IgAN or diabetic nephropathy, transplanted during the same period were analyzed. Correlates of biopsy-confirmed recurrent disease were determined.

STATISTICAL ANALYSIS:

Means were analyzed by Student's t test and Mann-Whitney test; proportions were determined by Chi-square analysis and graft survival curves were generated using the Kaplan-Meier.

RESULTS:

Five-year graft survival for IgA patients was not significantly different from that in the reference group (90% and 79%, P = 0.6). During a mean follow-up of 42 months (range, 1-144), 28 event graft biopsies were required in 20 grafts of IgAN. Histological recurrence was diagnosed in five of the 20 available biopsies (25%) after a mean duration of 28 months. Recurrence did not correlate with donor status, HLA B35 and A2, recipient age, gender or immunosuppression.

CONCLUSIONS:

Renal transplantation is an appropriate treatment modality for IgA nephropathy patients with end-stage renal disease in India, despite the potential for recurrent disease. The posttransplant course is an indolent one when compared to the malignant pretransplant phase.

PMID:
17495373
DOI:
10.4103/0022-3859.32207
[Indexed for MEDLINE]
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