Recurrence of Glomerular Diseases after Kidney Transplantation: What Do We Know New?

被引：0
作者：
Rodrigo, Emilio [1 ]
Belmar, Lara [1 ]
Perez-Canga, Jose Luis [2 ]
机构：
[1] Hosp Univ Marques Valdecilla, Nephrol Dept, IDIVAL, Santander, Spain
[2] Hosp Univ San Agustin, Nephrol Dept, Aviles, Spain
来源：
NEPHRON | 2025年
关键词：
Kidney transplantation; Glomerulonephritis; Graft loss; Recurrence; Risk factors; IGA NEPHROPATHY; MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS; POSTTRANSPLANT RECURRENCE; MEMBRANOUS NEPHROPATHY; PROTOCOL; GRAFT; PULSE; RISK;
D O I：
10.1159/000543268
中图分类号：
R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];
学科分类号：
1002 ; 100201 ;
摘要：
Background: The recurrence of primary glomerulonephritis (GN) following kidney transplantation poses a significant threat to graft survival. To enhance kidney transplant outcomes, we must lessen the burden of recurrence. In recent years, there has been progress in understanding the incidence, risk factors for recurrence, pathophysiology, biomarkers, and therapeutics, making it worthwhile to conduct an update on primary GN that may recur following kidney transplantation. Summary: We conducted a narrative review of the literature on the novel discoveries of primary GN that can recur following kidney transplantation. To summarize, developing a broad consensus on recurrence diagnosis would greatly advance our understanding, and its development would be a valuable collaborative effort. The key risk factors for recurrence have been better understood, particularly in individuals with complement-related or monoclonal gammopathy-related recurrent membranoproliferative GN. Furthermore, we can identify better recurrent IgA nephropathy patients who are more likely to experience graft loss. New biomarkers for membranous nephropathy (anti-PLA2R-Ab) and focal and segmental glomerulosclerosis (anti-nephrin-Ab) can assist in identifying and monitoring patients at risk of recurrence. Regarding therapy, the focal and segmental glomerulosclerosis consensus will enhance recurrence treatment. Some complement inhibitors and anti-CD38 monoclonal antibodies are already promising in treating and healing recurrent C3 glomerulopathy and focal and segmental glomerulosclerosis, respectively. Finally, new drugs developed specifically to treat IgA nephropathy in the native kidney will also change the outcome of IgA nephropathy recurrence. Key Messages: Although there has been progress in understanding the recurrence of primary GN following kidney transplantation, a worldwide effort should be undertaken to gather research that will allow for improved diagnosis, monitoring, and management of these patients.
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页数：12
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  • [1] Allen P.J., Chadban S.J., Craig J.C., Lim W.H., Allen R.D.M., Clayton P.A., Et al., Recurrent glomerulonephritis after kidney transplantation: Risk factors and allograft outcomes, Kidney Int., 92, 2, pp. 461-469, (2017)
  • [2] Briganti E.M., Russ G.R., McNeil J.J., Atkins R.C., Chadban S.J., Risk of renal allograft loss from recurrent glomerulonephritis, N Engl J Med., 347, 2, pp. 103-109, (2002)
  • [3] Cosio F.G., Cattran D.C., Recent advances in our understanding of recurrent primary glomerulonephritis after kidney transplantation, Kidney Int., 91, 2, pp. 304-314, (2017)
  • [4] Ponticelli C., Glassock R.J., Posttransplant recurrence of primary glomerulonephritis, Clin J Am Soc Nephrol., 5, 12, pp. 2363-2372, (2010)
  • [5] Raina R., Jothi S., Haffner D., Somers M., Filler G., Vasistha P., Et al., Post-transplant recurrence of focal segmental glomerular sclerosis: Consensus statements, Kidney Int., 105, 3, pp. 450-463, (2024)
  • [6] Uffing A., Perez-Saez M.J., Mazzali M., Manfro R.C., Bauer A.C., De Sottomaior Drumond F., Et al., Recurrence of FSGS after kidney transplantation in adults, Clin J Am Soc Nephrol., 15, 2, pp. 247-256, (2020)
  • [7] Uffing A., Hullekes F., Riella L.V., Hogan J.J., Recurrent glomerular disease after kidney transplantation: Diagnostic and management dilemmas, Clin J Am Soc Nephrol., 16, 11, pp. 1730-1742, (2021)
  • [8] Shoji J., Mii A., Terasaki M., Shimizu A., Update on recurrent focal segmental glomerulosclerosis in kidney transplantation, Nephron., 144, pp. 65-70, (2020)
  • [9] Delville M., Sigdel T.K., Wei C., Li J., Hsieh S.C., Fornoni A., Et al., A circulating antibody panel for pretransplant prediction of FSGS recurrence after kidney transplantation, Sci Transl Med., 6, 256, (2014)
  • [10] Shirai Y., Miura K., Ishizuka K., Ando T., Kanda S., Hashimoto J., Et al., A multi-institutional study found a possible role of anti-nephrin antibodies in post-transplant focal segmental glomerulosclerosis recurrence, Kidney Int., 105, 3, pp. 608-617, (2024)
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