title: Transplant glomerulopathy: clinical course and factors relating to graft survival.
abstract: BACKGROUND
  Transplant glomerulopathy (TG) is usually associated with a poor prognosis for kidney graft survival.
  
  
  OBJECTIVE
  We analyzed 30 cases of TG diagnosed by kidney biopsy among a retrospective review of 579 biopsies performed between January 2006 and October 2011.
  
  
  RESULTS
  At the time of biopsy, the mean glomerular filtration rate (GFR), estimated by the abbreviated Modification of Diet in Renal Disease was 31 ± 10 mL/min and the proteinuria, 1.9 ± 2 gr/24 hours. Anti-human leukocyte antigen (HLA) antibodies were present in 40% of patients. The histological findings showed severe duplication of the glomerular basement membrane in 80% of patients; and interstitial fibrosis and tubular atrophy (IFTA) and moderate to severe arteriolar hyalinosis in 53% and 56% respectively. Fourteen patients lost their grafts. Graft survival was significantly associated with IFTA (P = .03) and renal function at the time of diagnosis (P = .03).
  
  
  CONCLUSIONS
  TG was associated with a worse prognosis for the graft among kidney transplant patients. It is often associated with the presence of anti-HLA antibodies. Renal function at the time of diagnosis and IFTA were predictive factors for graft survival in these patients.
authors.affiliation: Nephrology Department, H.U. Carlos Haya, Malaga, Spain. verolopezjim@yahoo.es
authors.forename: V
authors.initials: V
authors.lastname: López Jiménez
authors.forename: L
authors.initials: L
authors.lastname: Fuentes
authors.forename: T
authors.initials: T
authors.lastname: Jiménez
authors.forename: M
authors.initials: M
authors.lastname: León
authors.forename: I
authors.initials: I
authors.lastname: Garcia
authors.forename: E
authors.initials: E
authors.lastname: Sola
authors.forename: M
authors.initials: M
authors.lastname: Cabello
authors.forename: C
authors.initials: C
authors.lastname: Gutierrez
authors.forename: D
authors.initials: D
authors.lastname: Burgos
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.forename: D
authors.initials: D
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D001284:Atrophy; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D050533:Glomerular Basement Membrane / Q000473:pathology; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies