Kanbay Mehmet, Ozbek Lasin, Guldan Mustafa, Copur Sidar, Barratt Jonathan
Division of Nephrology, Department of Internal Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey.
Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
J Nephrol. 2024 Nov 20. doi: 10.1007/s40620-024-02149-6.
IgA nephropathy is the commonest pattern of primary glomerular disease in the world, with high rates of progression to kidney failure. As IgA nephropathy commonly causes kidney failure at a young age, kidney transplantation is commonly used to treat kidney failure. However, high rates of recurrent disease in the allograft remain a common management challenge. The prevalence of post-transplant recurrence approaches 15% at ten years post-transplant and is associated with poor allograft function and high rates of allograft loss. Post-transplant IgA nephropathy has also been described de novo in some case series. Treatment of recurrent IgA nephropathy has been challenging but with the rapid growth of new treatments for IgA nephropathy it is likely that many of these treatments will, over time, transition to the treatment of recurrent disease. In this narrative review, our aim is to evaluate post-transplant IgA nephropathy in terms of epidemiology, risk factors, underlying pathophysiology, diagnosis and management strategies.
IgA肾病是全球原发性肾小球疾病最常见的类型，进展至肾衰竭的比例很高。由于IgA肾病通常在年轻时导致肾衰竭，肾移植常用于治疗肾衰竭。然而，同种异体移植物中疾病复发率高仍是一个常见的管理挑战。移植后复发的患病率在移植后十年接近15%，并与同种异体移植物功能不佳和同种异体移植物丢失率高有关。在一些病例系列中也有新发移植后IgA肾病的描述。复发性IgA肾病的治疗一直具有挑战性，但随着IgA肾病新治疗方法的迅速发展，随着时间的推移，这些治疗方法中的许多可能会转变为复发性疾病的治疗方法。在这篇叙述性综述中，我们的目的是从流行病学、危险因素、潜在病理生理学、诊断和管理策略等方面评估移植后IgA肾病。
