PMID- 32187607 OWN - NLM STAT- MEDLINE DCOM- 20210526 LR - 20210526 IS - 1421-9670 (Electronic) IS - 0250-8095 (Linking) VI - 51 IP - 5 DP - 2020 TI - IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch. PG - 357-365 LID - 10.1159/000506853 [doi] AB - BACKGROUND: Recurrence of immunoglobulin (Ig)A nephropathy (rIgAN) is a growing cause of kidney allograft dysfunction. This study was aimed at investigating factors associated with rIgAN and the subsequent progression to end-stage renal disease (ESRD). METHODS: Retrospective study including consecutive patients with IgA nephropathy (IgAN) who received a kidney transplant in our center between 1992 and 2016 and had a renal biopsy by clinical indication. The date of detection of chronic kidney disease (CKD) 5 was used as renal outcome. RESULTS: Eighty-six kidney transplants were performed in patients with IgAN, 38 (44%) were from living donors (related n = 26). rIgAN was diagnosed in 23 allografts (27%). Renal function and proteinuria at the end of the follow-up period were worst in the rIgAN patients compared to those without rIgAN (2.2 vs. 1.4 mg/dL, p = 0.014, and 1.16 vs. 0.49 g/day, p = 0.005, respectively). Risk of rIgAN and progression to CKD 5 decreased with patient's age (hazard ratio [HR] 0.95, 95% CI 0.92-0.98, p = 0.002, and HR 0.97, 95% CI 0.83-0.97, p = 0.008 per year, respectively). Patients with rIgAN had a higher risk of progression to CKD 5 (HR 6.7, 95% CI 1.3-35.7, p = 0.025). Full donor-recipient mismatch in the human leukocyte antigen (HLA)-B loci decreased the risk of rIgAN (HR 0.22, 95% CI 0.06-0.76, p = 0.017). CONCLUSIONS: rIgAN was an independent risk factor for ESRD after renal allograft. Younger age increased the risk of rIgAN and CKD 5. Conversely, HLA-B mismatching was a potential protective factor for rIgAN of this glomerular disease. CI - (c) 2020 S. Karger AG, Basel. FAU - Rodas, Lida M AU - Rodas LM AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain, lmrodas@clinic.cat. AD - Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Barcelona, Spain, lmrodas@clinic.cat. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain, lmrodas@clinic.cat. FAU - Ruiz-Ortiz, Estibaliz AU - Ruiz-Ortiz E AD - Department of Immunology, Hospital Clinic, Barcelona, Spain. FAU - Garcia-Herrera, Adriana AU - Garcia-Herrera A AD - Department of Pathology, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Barcelona, Spain. FAU - Pereira, Arturo AU - Pereira A AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Blasco, Miquel AU - Blasco M AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Ventura-Aguiar, Pedro AU - Ventura-Aguiar P AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Vinas Gomis, Odette AU - Vinas Gomis O AD - Department of Immunology, Hospital Clinic, Barcelona, Spain. FAU - Egri, Natalia AU - Egri N AD - Department of Immunology, Hospital Clinic, Barcelona, Spain. FAU - De Sousa, Erika AU - De Sousa E AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Palou, Eduard AU - Palou E AD - Department of Immunology, Hospital Clinic, Barcelona, Spain. FAU - Diekmann, Fritz AU - Diekmann F AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Poch, Esteban AU - Poch E AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Campistol, Josep M AU - Campistol JM AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. FAU - Quintana, Luis Fernando AU - Quintana LF AD - Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain. AD - Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20200318 PL - Switzerland TA - Am J Nephrol JT - American journal of nephrology JID - 8109361 RN - 0 (HLA-B Antigens) SB - IM MH - Adult MH - Age Factors MH - Allografts/immunology/pathology MH - Biopsy MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Glomerulonephritis, IGA/complications/*diagnosis/immunology/surgery MH - HLA-B Antigens/analysis/*immunology MH - Histocompatibility Testing MH - Humans MH - Kidney/immunology/pathology MH - Kidney Failure, Chronic/immunology/*surgery MH - Kidney Transplantation/*adverse effects MH - Male MH - Middle Aged MH - Protective Factors MH - Recurrence MH - Retrospective Studies MH - Risk Factors MH - Transplantation, Homologous OTO - NOTNLM OT - Chronic allograft dysfunction OT - Glomerular diseases OT - Human leukocyte antigen mismatch OT - Immunoglobulin A nephropathy OT - Recurrence after transplantation EDAT- 2020/03/19 06:00 MHDA- 2021/05/27 06:00 CRDT- 2020/03/19 06:00 PHST- 2019/11/11 00:00 [received] PHST- 2020/02/28 00:00 [accepted] PHST- 2020/03/19 06:00 [pubmed] PHST- 2021/05/27 06:00 [medline] PHST- 2020/03/19 06:00 [entrez] AID - 000506853 [pii] AID - 10.1159/000506853 [doi] PST - ppublish SO - Am J Nephrol. 2020;51(5):357-365. doi: 10.1159/000506853. Epub 2020 Mar 18.