European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.2.5. Chronic graft dysfunction. Late recurrence of primary glomerulonephritides.
A. In the case of recurrent focal and segmental glomerulosclerosis (FSGS), aggressive treatment with high-dose cyclosporine in children, ACE inhibitors and/or Angiotensin II antagonists, plasma exchange or immunoadsorption may result in remission in some patients. B. In the case of recurrent membranous nephropathy (MN), there is no specific treatment. However, control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, and prevention of thrombotic complications are recommended. C. In the case of recurrent membranoproliferative glomerulonephritis (MPGN), there is no specific treatment. However, control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, and prevention of thrombotic complications are recommended. D. In the case of recurrent IgA glomerulonephritis, use of additional steroids is not yet a validated treatment. The control of risk factors, such as hypertension, heavy proteinuria and hyperlipidaemia, is recommended. E. In the rare case of recurrent anti-glomerular basement membrane (anti-GBM) glomerulonephritis with reappearance of anti-GBM antibodies, it is recommended to initiate plasma exchange and to treat with appropriate immunosuppressive agents (e.g. cyclophosphamide).
D019867:Anti-Glomerular Basement Membrane Disease / Q000628:therapy; D002908:Chronic Disease; D005921:Glomerulonephritis / Q000628:therapy*; D005922:Glomerulonephritis, IGA / Q000628:therapy; D015432:Glomerulonephritis, Membranoproliferative / Q000628:therapy; D005923:Glomerulosclerosis, Focal Segmental / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D012008:Recurrence