[Recurrent kidney disease and its prevention after renal transplantation. Review of the literature].
Recurrence of the initial renal disease after kidney transplantation is a major cause of graft dysfunction and failure. Glomerulopathies are reported to account for 80% of such cases, but this figure should be interpreted with care, as extensive investigations (immunofluorescence or electron microscopy studies of the explanted kidney) are needed to prove that the initial disease has indeed recurred and to determine prevalence rates. In the following order of frequency, focal segmental glomerulosclerosis, membranous glomerulonephritis, mesangiocapillary glomerulonephritis and IgA nephropathy have a tendency to recur, while, surprisingly, anti-glomerular basement membrane nephritis and systemic lupus erythematosus are less likely to relapse on the donor kidney. There is no evidence that anti-calcineurin therapy has any impact on the risk of recurrence. Options for the prevention and treatment of these recurrences are very limited, calling for very cautious use of living familial donors.
Charpentier
Bernard
B
Service de néphrologie, CHU de Bicêtre, 94275 Kremlin Bicêtre.
D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000517:prevention & control; D016030:Kidney Transplantation / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000209:etiology / Q000517:prevention & control; D055502:Secondary Prevention