Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.

<h4>Objectives</h4>Kidney transplant (KTx) recipients with IgAN as primary disease, were compared with recipients with other causes of renal failure, in terms of long-term outcomes.<h4>Methods</h4>Ninety-nine KTx recipients with end-stage kidney disease (ESKD) due to IgAN, we...

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Autores principales:	Sophia Lionaki, Ilias Makropoulos, Konstantinos Panagiotellis, George Vlachopanos, Ioannis Gavalas, Smaragdi Marinaki, George Liapis, Ioannis Michelakis, Ioannis Bokos, Ioannis Boletis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/86f0fdb4ad944c3faace1aa0f1cb0f35
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spelling	oai:doaj.org-article:86f0fdb4ad944c3faace1aa0f1cb0f352021-12-02T20:18:00ZKidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.1932-620310.1371/journal.pone.0253337https://doaj.org/article/86f0fdb4ad944c3faace1aa0f1cb0f352021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253337https://doaj.org/toc/1932-6203<h4>Objectives</h4>Kidney transplant (KTx) recipients with IgAN as primary disease, were compared with recipients with other causes of renal failure, in terms of long-term outcomes.<h4>Methods</h4>Ninety-nine KTx recipients with end-stage kidney disease (ESKD) due to IgAN, were retrospectively compared to; i/ a matched case-control group of patients with non-glomerular causes of ESKD, and ii/ four control groups with ESKD due to glomerular diseases; 44 patients with primary focal segmental glomerulosclerosis (FSGS), 19 with idiopathic membranous nephropathy (IMN), 22 with lupus nephritis (LN) and 21 with pauci-immune glomerulonephritis (PIGN).<h4>Results</h4>At end of the observation period, graft function and survival, were similar between KTx recipients with IgAN and all other groups, but the rate of disease recurrence in the graft differed significantly across groups. The rate of IgAN recurrence in the graft was 23.2%, compared to 59.1% (p<0.0001) in the FSGS group, 42.1% (p = 0.17) in the IMN group, and 0% in the LN and PIGN groups (p = 0.01). IgAN recipients, who were maintained with a regimen containing tacrolimus, experienced recurrence less frequently, compared to those maintained with cyclosporine (p = 0.01). Graft loss attributed to recurrence was significantly higher in patients with FSGS versus all others.<h4>Conclusion</h4>Recipients with IgAN as primary disease, experienced outcomes comparable to those of recipients with other causes of ESKD. The rate of IgAN recurrence in the graft was significantly lower than the rate of FSGS recurrence, but higher than the one recorded in recipients with LN or PIGN. Tacrolimus, as part of the KTx maintenance therapy, was associated with lower rates of IgAN recurrence in the graft, compared to the rate cyclosporine.Sophia LionakiIlias MakropoulosKonstantinos PanagiotellisGeorge VlachopanosIoannis GavalasSmaragdi MarinakiGeorge LiapisIoannis MichelakisIoannis BokosIoannis BoletisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0253337 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sophia Lionaki Ilias Makropoulos Konstantinos Panagiotellis George Vlachopanos Ioannis Gavalas Smaragdi Marinaki George Liapis Ioannis Michelakis Ioannis Bokos Ioannis Boletis Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
description	<h4>Objectives</h4>Kidney transplant (KTx) recipients with IgAN as primary disease, were compared with recipients with other causes of renal failure, in terms of long-term outcomes.<h4>Methods</h4>Ninety-nine KTx recipients with end-stage kidney disease (ESKD) due to IgAN, were retrospectively compared to; i/ a matched case-control group of patients with non-glomerular causes of ESKD, and ii/ four control groups with ESKD due to glomerular diseases; 44 patients with primary focal segmental glomerulosclerosis (FSGS), 19 with idiopathic membranous nephropathy (IMN), 22 with lupus nephritis (LN) and 21 with pauci-immune glomerulonephritis (PIGN).<h4>Results</h4>At end of the observation period, graft function and survival, were similar between KTx recipients with IgAN and all other groups, but the rate of disease recurrence in the graft differed significantly across groups. The rate of IgAN recurrence in the graft was 23.2%, compared to 59.1% (p<0.0001) in the FSGS group, 42.1% (p = 0.17) in the IMN group, and 0% in the LN and PIGN groups (p = 0.01). IgAN recipients, who were maintained with a regimen containing tacrolimus, experienced recurrence less frequently, compared to those maintained with cyclosporine (p = 0.01). Graft loss attributed to recurrence was significantly higher in patients with FSGS versus all others.<h4>Conclusion</h4>Recipients with IgAN as primary disease, experienced outcomes comparable to those of recipients with other causes of ESKD. The rate of IgAN recurrence in the graft was significantly lower than the rate of FSGS recurrence, but higher than the one recorded in recipients with LN or PIGN. Tacrolimus, as part of the KTx maintenance therapy, was associated with lower rates of IgAN recurrence in the graft, compared to the rate cyclosporine.
format	article
author	Sophia Lionaki Ilias Makropoulos Konstantinos Panagiotellis George Vlachopanos Ioannis Gavalas Smaragdi Marinaki George Liapis Ioannis Michelakis Ioannis Bokos Ioannis Boletis
author_facet	Sophia Lionaki Ilias Makropoulos Konstantinos Panagiotellis George Vlachopanos Ioannis Gavalas Smaragdi Marinaki George Liapis Ioannis Michelakis Ioannis Bokos Ioannis Boletis
author_sort	Sophia Lionaki
title	Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
title_short	Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
title_full	Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
title_fullStr	Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
title_full_unstemmed	Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
title_sort	kidney transplantation outcomes in patients with iga nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/86f0fdb4ad944c3faace1aa0f1cb0f35
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Kidney transplantation outcomes in patients with IgA nephropathy and other glomerular and non-glomerular primary diseases in the new era of immunosuppression.

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