Clinicopathologic features and prognosis of IgA nephropathy after kidney transplantation
10.3760/cma.j.issn.0254-1785.2020.02.007
- VernacularTitle:供肾移植术后IgA肾病的临床病理特点与预后的关系
- Author:
Chunyun ZHANG
1
;
Hongyan ZHU
;
Qiuxiang XIA
;
Zhendi WANG
;
Hua SU
Author Information
1. 华中科技大学同济医学院附属协和医院肾内科，武汉 430022
- From:
Chinese Journal of Organ Transplantation
2020;41(2):89-93
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinicopathologic features and risk factors of IgA nephropathy (IgAN) after kidney transplantation.Methods:A retrospective analysis was conducted for biopsy-confirmed IgAN patients after transplantation from January 2016 to September 2019. The clinicopathological characteristics and risk factors of IgAN after expanded criteria donor (ECD) donor for kidney transplantation were examined by statistical analysis of general clinical data and Oxford classification during and after transplantation.Results:The diagnostic rate of IgAN after transplantation was around 12.77%. The clinical symptoms occurred at an average of 22.5 months after transplantation. 66.67%(12/18) patients were in stage 3-4 chronic kidney disease (CKD). There were microscopic hematuria (76.92%) and varying degrees of proteinuria (88.89%). The scores of pathological parameters were as follows: 78% patients with mesangial cell proliferation (M1), 17% with endothelial cell proliferation (E1), 65% with segmental sclerosis (S1), 39% with moderate-to-severe tubules atrophy/interstitial fibrosis (T1/T2) and 17% with crescent formation (C1) respectively. Tubuloatrophy/interstitial fibrosis was associated with estimated glomerular filtration rate (eGFR) at biopsy ( P<0.05). Group of urine protein quantification >1g/d and group of <1g/d group had statistically significant differences in segmental sclerosis and adhesion lesion ( P<0.05). Conclusions:Oxford classification is valuable in the clinical evaluations of allograft IgAN: Tubular atrophy/interstitial fibrosis is associated with a decline of glomerular filtration. And segmental sclerosis and adhesion lesion are correlated with the severity of proteinuria.
