Glomerulonephritis in renal allografts: results of 18 years of transplantations.

The analysis of 1282 renal transplantations revealed 13 cases of allograft glomerulonephritis (GN). Membranous GN was detected in seven patients, and mesangiocapillary GN type 1, IgA GN and focal segmental glomerulosclerosis in two patients each. The transplantation material included 13 patients with post-transplant nephrotic syndrome (NS), in 9 of whom it was evidently caused by GN. NS was the most common clinical sign of allograft GN. In addition, one patient developed low-grade proteinuria and one hematuria. In one case no signs of GN were detected at the time of graft biopsy. Loss of allograft function was associated with additional severe rejection changes. Five patients are living with a functioning graft, four have been started on hemodialysis and four have died form non-renal causes. It is concluded that NS is rare after renal transplantation and that it is most often caused by allograft GN. The prognosis of the graft is determined by co-existing rejection.