Clinicaland prognostic features of lipoprotein glomerulopathy in renal allografts
10.3760/cma.j.issn.0254-1785.2019.10.009
- VernacularTitle: 移植肾脂蛋白肾病的临床研究
- Author:
Jin ZHANG
1
;
Xutao CHEN
;
Gang HUANG
;
Jiang QIU
;
Guodong CHEN
;
Lizhong CHEN
;
Jiguang FEI
;
Changxi WANG
Author Information
1. Department of Organ Transplant, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
- Publication Type:Clinical Trail
- Keywords:
Kidney transplantation;
Renal needle biopsy;
Apolipoprotein E
- From:
Chinese Journal of Organ Transplantation
2019;40(10):620-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical and prognostic features of lipoprotein glomerulopathy (LPG) in renal allografts.
Methods:Retrospective analysis was performed for two case of LPG in renal allografts. The onset time was 6 and 9 years after living transplantation respectively. Initial symptoms included proteinuria and hypoproteinemia. Color Doppler ultrasound showed an enlarged graft size and greater parenchymal echogenicity. One patient had hyperlipemia and elevated apolipoprotein E (ApoE). Methylprednisolone pulse was offered with an early control of hyperlipidaemia and proteinuria by fenofibrate and angiotensin-converting enzyme inhibitors (ACEIs). Yet it had no effect on graft function. The definite diagnosis was made by graft biopsy. Pathological examination indicated non-homogeneous lipid deposition in glomerular capillary, glomerular sclerosis, mesangial hypercellularity and tubular atrophy.
Results:During a follow-up period of 8 and 10 years post-transplantation, two cases eventually lost their grafts within 2 and 1 year after biopsy respectively. With long-term dietary control and drug therapy, regular dialysis continued and both awaited a second transplantation.
Conclusions:LPG is generally steroid-resistant and refractory in renal allografts. And routine biopsy is recommended for patients with a high risk of occurrence. Early controls of hyperlipemia and hypoproteinemia and other risk factors should be also properly managed.
