Outcome of 313 Czech Patients With IgA Nephropathy After Renal Transplantation

The recurrence of IgA nephropathy (IgAN) after kidney transplant is often with the range among 20 – 35 %. The main aim of our study was to evaluate the risk factors affecting the course of IgAN after renal biopsy of native kidney and kidney transplant. We evaluated clinical parameters and histological findings at the time of biopsy of native kidney and after kidney transplant in 313 patients with IgAN during follow up of 36 years. Using hierarchial clustering method patients with graft failure were divided into two groups according to the time from kidney transplant to graft failure (11.2 versus 6.1 years) which excellently correlated with the distribution of two groups based on the time from the renal biopsy of native kidney to end stage renal disease (5.9 versus 0.4 years). Body mass index, proteinuria, microscopic hematuria, histological evaluation of fibrosis and crescents at the time of renal biopsy of native kidney were confirmed for the differentiation into two groups. Higher age of donor kidney transplant, histological verified recurrence of IgAN, antibody mediated rejection and the onset of microscopic hematuria and proteinuria till one year after kidney transplant were also confirmed for worse graft survival in multivariate Cox regression analysis in patients with original diagnosis of IgAN in native kidney biopsy.