Recurrent Immunoglobulin A Nephropathy after Kidney Transplant—An Updated Review.

Immunoglobulin A nephropathy (IgAN) is the commonest glomerulonephritis worldwide, a category that represents the third most frequent cause of end-stage kidney disease (ESKD) in the United States. Kidney transplantation remains the optimal treatment of ESKD, and yet the prospects of IgAN recurrence...

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Publicado en:Transplantology Vol. 4; no. 3; pp. 161 - 178
Autores principales: Han, Hwarang S., Lubetzky, Michelle L., Anandasivam, Nidharshan S., Cox, Rebecca A., Lee, Brian K.
Formato: review tables/charts Journal Article
Publicado: MDPI Sep2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2023
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      pub: MDPI
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        atl: Recurrent Immunoglobulin A Nephropathy after Kidney Transplant—An Updated Review.
      aug:
        au:
          Han, Hwarang S.
          Lubetzky, Michelle L.
          Anandasivam, Nidharshan S.
          Cox, Rebecca A.
          Lee, Brian K.
        affil: Division of Nephrology, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA
      sug:
        subj:
          Kidney Transplantation Adverse Effects
          Glomerulonephritis Risk Factors
          Recurrence Risk Factors
          Glomerulonephritis Diagnosis
          Recurrence Diagnosis
          Glomerulonephritis Pathology
          Glomerulonephritis Symptoms
          Glomerulonephritis Therapy
          Proteinuria Prevention and Control
          Immunosuppression
      ab: Immunoglobulin A nephropathy (IgAN) is the commonest glomerulonephritis worldwide, a category that represents the third most frequent cause of end-stage kidney disease (ESKD) in the United States. Kidney transplantation remains the optimal treatment of ESKD, and yet the prospects of IgAN recurrence post-transplant dampens the enthusiasm for living kidney donation in some instances, in addition to limiting the longevity of the kidney allograft. Moreover, the lack of a standardized method for detecting IgAN recurrence, since not all centers perform protocol allograft biopsies, has led to an underestimation of the extent of the issue. The pathogenesis of de novo IgAN remains conjectural, let alone the pathways for recurrent disease, but is increasingly recognized as a multi-hit injury mechanism. Identification of recurrent disease rests mainly on clinical symptoms and signs (e.g., hematuria, proteinuria) and could only be definitively proven with histologic evidence which is invasive and prone to sampling error. Treatment had relied mainly on nonspecific goals of proteinuria reduction, and in some cases, immunosuppression for active, crescentic disease. More recently, newer targets have the potential to widen the armamentarium for directed therapies, with more studies on the horizon. This review article provides an update on recurrent IgAN post-transplant.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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