Incidence and risk factors for recurrent membranous nephropathy after kidney transplantation: a systematic review and

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Jiang Bai1, Zhifang Zheng2, Jiajing Cao1

  • 1Second Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China.

Annals of Medicine
|June 27, 2025
PubMed
Abstract

Insights

Recurrent membranous nephropathy (MN) after kidney transplant is common. Living donors, high anti-PLA2R antibody levels, and shorter dialysis increase risk, while certain immunosuppressants offer protection.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Clinical Epidemiology

Background:

  • Membranous nephropathy (MN) recurrence post-kidney transplant presents diagnostic challenges due to unclear risk factors.
  • Identifying predictive clinical features is crucial for managing recurrent MN.

Purpose of the Study:

  • To systematically review and analyze risk factors associated with recurrent MN after kidney transplantation.
  • To provide evidence-based insights for clinical decision-making in transplant recipients.

Main Methods:

  • A systematic review and meta-analysis of case-control studies published up to March 2023.
  • Searched multiple databases (PubMed, Embase, Web of Science, etc.) for relevant studies.
  • Statistical analysis performed using Stata 12.0, protocol registered on PROSPERO.

Main Results:

  • The incidence of recurrent MN was 34%, with higher detection rates via surveillance biopsies.
  • Risk factors included living donors, pre-transplant anti-phospholipase A2 receptor autoantibody (anti-PLA2R) levels, and shorter dialysis duration.
  • Induction immunosuppression and tacrolimus use were identified as protective factors.

Conclusions:

  • Recurrent MN remains a significant concern post-transplantation.
  • Clinical evaluation should prioritize living donor selection, pre-transplant anti-PLA2R levels, dialysis duration, and immunosuppressive strategies.
Keywords:
Meta-analysisincidencekidney transplantationprimary membranous nephropathyrisk factors

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