title: Glomerular pathology of allograft kidneys in Hong Kong.
abstract: OBJECTIVE
  Our goal was to define the spectrum of glomerular diseases in allograft kidneys and to correlate them with clinical parameters.
  
  
  METHODS
  Eight hundred ninety-one renal graft biopsies and 43 graft nephrectomies from 1980 to 2004 were obtained from 442 allografts transplanted to 425 patients.
  
  
  RESULTS
  Glomerular diseases were diagnosed in 33% of kidney grafts. Indications for biopsy were baseline assessment (23 biopsies, 2.5%); renal dysfunction (790 biopsies, 88.7%); proteinuria (154 biopsies, 17.3%); hematuria (11 biopsies, 1.2%); and study protocol (four biopsies, 0.4%). The median time to take a biopsy was less than 8 months posttransplant. The mean time posttransplant when the biopsy diagnosis was made was 70 months for IgA nephropathy (IgAN); 66 months for transplant glomerulopathy (TG); 65 months for focal segmental glomerulosclerosis (FSG); 55 months for mesangiocapillary glomerulonephritis (MCGN); 45 months for membranous glomerulonephritis (GN); 49 months for mesangial proliferative GN; and 101 months for diabetic nephropathy. Recurrent glomerular disease was documented in 31 (7.0%) grafts. Specific glomerular diseases were diagnosed by biopsies in 106 (89.1%) of 119 proteinuric allografts.
  
  
  CONCLUSIONS
  Glomerulopathy was common in allografted kidneys. IgAN, TG, FSG, mesangial proliferative GN, and membranous GN were the majority. A higher proportion of grafts from donors related to the recipients than from unrelated donors showed IgAN (P < .05), suggesting that genetic factors might play a role in the pathogenesis of IgAN. Recurrence of glomerulopathy underlying ESRD was frequent for IgAN, FSG, and MCGN, but this was rarely seen in membranous GN.
authors.affiliation: Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, China. kwchan@pathology.hku.hk
authors.forename: K W
authors.initials: KW
authors.lastname: Chan
authors.forename: G S W
authors.initials: GS
authors.lastname: Chan
authors.forename: S
authors.initials: S
authors.lastname: Tang
mesh_terms: D001706:Biopsy; D002102:Cadaver; D006723:Hong Kong; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007674:Kidney Diseases / Q000145:classification / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology*; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology*; D019520:Living Donors; D009392:Nephrectomy; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000473:pathology
chemical_list: D007070:Immunoglobulin A