Abstract
BackgroundPost-transplant recurrent nephritis is the third common complication that leads to graft loss, which affects the long-term graft survival of kidney transplant patients. Immunoglobulin A nephropathy (IgAN) is the most common for recurrent nephritis, with a recurrence rate of 13–53%. In this study, 12 patients diagnosed with recurrent IgAN were divided into two groups, one which underwent tonsillectomy and another which did not, to analyze the effect of treating IgAN recurrent with or without tonsillectomy.MethodsUrinary findings, estimated GFR (eGFR), and histopathological alteration (Banff and Oxford classifications) were examined for >5 years after kidney transplantation.ResultsWe found that tonsillectomy protected graft function and prevented pathological alterations. The levels of urinary proteins increased in the no tonsillectomy group, whereas no difference was observed in the severity of hematuria between two groups. eGFR declined and mesangial hypercellularity score increased in the no tonsillectomy group.ConclusionsTonsillectomy not only results in a favorable clinical outcome but also protects against the histological damage caused by recurrent IgAN after kidney transplantation.
Highlights
Post-transplant recurrent nephritis is the third common complication that leads to graft loss, which affects the long-term graft survival of kidney transplant patients
We evaluated the efficacy of tonsillectomy for the treatment of Immunoglobulin A nephropathy (IgAN) recurrence after kidney transplantation
angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) therapy was initiated after IgAN recurrence was confirmed in all but one patient
Summary
Post-transplant recurrent nephritis is the third common complication that leads to graft loss, which affects the long-term graft survival of kidney transplant patients. Immunoglobulin A nephropathy (IgAN) is the most common for recurrent nephritis, with a recurrence rate of 13–53%. 12 patients diagnosed with recurrent IgAN were divided into two groups, one which underwent tonsillectomy and another which did not, to analyze the effect of treating IgAN recurrent with or without tonsillectomy. The recurrence rate of IgAN in renal graft is 13–53% among transplant recipients with IgAN, which affects long-term graft survival [1, 2]. In another study of 532 transplant recipients by Esther et al, graft loss due to IgAN recurrence occurred in as many as 9.7% patients at 10 years. We evaluated the efficacy of tonsillectomy for the treatment of IgAN recurrence after kidney transplantation
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