POS-762 IgA NEPHROPATHY IN KIDNEY TRANSPLANT RECIPIENTS: ONE CENTER EXPERIENCE

Abstract

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis leading to end-stage kidney disease. Every year more and more patients with IgAN undergo kidney transplantation and each of these patients has the risk of recurrence in their renal transplant. As overall kidney graft survival rate has been improved the prevalence of recurrent glomerulonephritis, in particular IgA nephropathy, is expected to increase. Data from 612 kidney transplant biopsies performed in Minsk, Belarus from 2015 to 2020 were retrospectively evaluated. Cases of pre- and/or posttransplant IgA nephropathy were analyzed. 42 cases (6,86%) of posttransplant IgA nephropathy were identified. Only 8 of them (19%) had biopsy-proven IgA disease in native kidneys, so could be regarded as recurrent IgAN patients. Male to female ratio was 2:1. Mean age was 41,71 ± 11,78 years. Clinical indications for renal graft biopsy were: proteinuria more than 1.0 g per 24 hours with and without hematuria – 45,24%; proteinuria less than 1.0 g per 24 hours with and without hematuria – 42,86%; isolated hematuria – 9,52%; elevation in serum creatinine – 2,38%. The term from transplantation to IgAN revealing was from 1 to 122 month, with an average of 49,59 ± 30,34 month. 13 patients (30,95%) have lost their graft function and 11 of them (84,6%) had proteinuria greater than 1.0 g per day. The prevalence of IgA nephropathy in kidney transplant recipients was 6,68% and only 19% of posttransplant IgAN cases were considered as recurrent. The main clinical manifestation of IgAN in renal graft was proteinuria associated with hematuria. Graft survival rate was 69,05%. Such well-known risk factor of IgAN poor outcome in native kidneys as proteinuria more than 1.0 g per day potentially hold true to recurrent disease, as 84,6% of posttransplant IgAN patients with non-functional transplant had severe proteinuria. Histological verification of native kidney primary disease is definitely required for risk stratification and early recurrence predicting.