title: Prognostic factors for renal allograft survival in patients with immunoglobulin A nephropathy: a case control study.
abstract: The renal allograft survival rates of patients with immunoglobulin A nephropathy (IgAN), and patients with or without other glomerular diseases, have yet to be fully elucidated. In this study, the clinicopathological factors associated with long-term allograft survival for the prognosis of renal allograft recipients with IgAN were examined. All patients enrolled in this study were diagnosed with IgAN following clinical and pathological examinations. Patients underwent renal graft biopsy and were hospitalized at the Fuzhou General Hospital between June, 2004 and December, 2010. Common demographic and clinical indicators were recorded in patients who had graft loss and in those who had functional renal grafts. Forty-two of the 202 biopsy specimens (20.8%) met the diagnostic criteria for IgAN and were divided into two groups, the graft loss group (n=17) and the functional graft group (n=25). Patients were followed up for 1-257 months after kidney transplantation. The mean patient age was 40.6 ± 9.3 years at the time of renal graft biopsy. Examination results indicated concomitant proteinuria and hematuria in 25 patients (59.5%) and proteinuria alone in six patients (14.3%). Graft loss occurred in 17 patients during the follow-up period. Comparison of the graft loss and the functional graft groups indicated that patients in the graft loss group were more likely to have proteinuria (P=0.047), high creatinine levels at the time of biopsy (P=0.009), low glomerular filtration rates (P=0.013), low serum total protein (P=0.01), a high Banff score (P=0.001), extensive glomerulosclerosis (P=0.002), a greater likelihood of crescent formation (P=0.01), severe tubular atrophy (P=0.013) and more extensive interstitial fibrosis (P=0.033). However, the two groups showed no significant differences in blood pressure, hematuria, BUN, UA, Hb, TG and CHO levels. The allograft survival rate of patients with IgAN was identified to be similar to that of patients with and without other glomerular diseases.
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Jun-Qi
authors.initials: JQ
authors.lastname: Guo
authors.affiliation: Department of Urology, Jiaxing Traditional Chinese Medical Hospital, Jiaxing, Zhejiang 314000, P.R. China.
authors.forename: Bao-Lin
authors.initials: BL
authors.lastname: Song
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Zhi-Xian
authors.initials: ZX
authors.lastname: Wu
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Wei-Zhen
authors.initials: WZ
authors.lastname: Wu
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Liu-Tao
authors.initials: LT
authors.lastname: Luo
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Chen
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Fu-Qiang
authors.initials: FQ
authors.lastname: He
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Zheng
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Shun-Liang
authors.initials: SL
authors.lastname: Yang
authors.affiliation: Organ Transplant Institute, Fuzhou General Hospital, Fujian Medical University and Fujian Key Laboratory of Transplant Biology, Fuzhou, Fujian 350025, P.R. China.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Tan
mesh_terms: D000328:Adult; D064591:Allografts / Q000473:pathology*; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D005922:Glomerulonephritis, IGA / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011379:Prognosis; D015996:Survival Rate