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Collapsing Glomerulopathy- A Troublemaker for the Renal Allograft: Lessons Learnt.
K V Kanodia1, A V Vanikar1,2, L K Nigam1
1Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
Indian Journal of Nephrology
|September 15, 2017
Summary
Collapsing glomerulopathy (CG) is a kidney transplant complication. This study found CG occurred in 0.83% of biopsies, often leading to graft failure, but some patients achieved stable function.
Area of Science:
- Nephrology
- Transplantation Medicine
- Pathology
Background:
- Collapsing glomerulopathy (CG) is a severe kidney injury pattern.
- It is a recognized cause of rapid renal allograft failure.
- Understanding its prevalence and features in transplant recipients is crucial.
Purpose of the Study:
- To determine the prevalence of CG in renal allograft biopsies.
- To analyze the clinicopathological features of CG in kidney transplant recipients.
- To evaluate the prognosis of CG in this patient population.
Main Methods:
- Single-center retrospective study.
- Analysis of 2518 renal allograft biopsies from 2007-2015.
- Correlation of clinicopathological features and outcomes.
Main Results:
- CG prevalence was 0.83% (21/2518), increasing to 1.4% from 2012-2015.
- Common native kidney diseases included glomerulonephritis and hypertensive nephropathy.
- CG was associated with rejection, immunosuppression toxicity, and viral infections.
- Graft failure occurred in 52.38% of patients within a mean of 2.2 years.
- Stable graft function was achieved in 28.57% of patients.
Conclusions:
- Collapsing glomerulopathy is an important cause of renal allograft dysfunction and failure.
- It can occur alongside other complications like rejection and viral infections.
- While often leading to graft loss, some patients may achieve stable graft function with appropriate management.
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