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Membranous nephropathy: recurrence after kidney transplantation
R Marcen1, F Mampaso, J L Teruel
1Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Summary
Membranous nephropathy recurrence after kidney transplant is high, with a 50% rate in this study. While often leading to graft failure, spontaneous remission of proteinuria is possible in some kidney transplant recipients.
Area of Science:
- Nephrology
- Transplantation immunology
- Glomerular diseases
Background:
- Membranous nephropathy (MN) is a leading cause of renal failure in 5% of dialysis patients.
- Recurrent MN post-kidney transplant is rare, with only 33 reported cases.
- This study investigates MN recurrence in a cohort of renal allograft recipients.
Observation:
- Five patients with MN as the cause of renal failure received six renal allografts.
- Recurrence of MN was observed in 50% of the allografts (3 out of 6).
- Proteinuria manifested between 2 and 19 months post-transplant.
Findings:
- Three patients experienced recurrent membranous nephropathy, all on cyclosporine and prednisone.
- One patient achieved spontaneous remission of proteinuria and maintained good renal function for 5 years.
- Two patients showed progressive renal deterioration, requiring a return to hemodialysis despite increased immunosuppression.
Implications:
- Recurrence of MN in renal allografts has a high incidence in this series.
- MN recurrence is associated with a poor graft prognosis.
- Spontaneous remission of proteinuria is a possible outcome, offering hope for some patients.