title: IgA NEPHROPATHY IN PATIENTS RECEIVING A RENAL TRANSPLANT.
abstract: BACKGROUND
  IgA nephropathy (IgAN) is the third most frequent cause of renal graft loss among patients with primary glomerulonephritis.
  
  
  OBJECTIVE
  To assess clinical and laboratorial profile of patients with pre and/or post transplant IgAN, in addition to patient and graft survival in both groups.
  
  
  METHODS
  Data from 146 patients who had received a renal transplant were retrospectively collected and were divided in two groups: group 1-patients with biopsy-documented IgAN as the underlying native kidney disease (n = 128); group 2-patients who developed post-transplant IgAN independent of the underlying disease (n = 18).
  
  
  METHODS
  Patients submitted to renal transplantation (1998-2010) with pre and/or post transplant IgAN.
  
  
  METHODS
  Clinical and laboratorial evaluation of renal function of 146 post transplant IgAN patients.
  
  
  RESULTS
  Recipients and deceased donors exhibited a higher degree of HLA compatibility (1.0 vs. 2.5 mismatches for groups 1 and 2, respectively). The main post-transplant IgAN presentation was haematuria associated with non-nephrotic proteinuria (44.4%). A histological pattern of focal segmental glomerulosclerosis was observed in 59.2% of biopsy samples. The 10-year patient survival was 93.5% in group 1 and 100% in group 2, and the graft survival rates were 58.5 and 87.2%, respectively.
  
  
  CONCLUSIONS
  The rate of post-transplant IgA diagnosis in our case series was 11%, and IgAN was diagnosed late in the course of transplantation. In most cases, IgAN manifested as haematuria and non-nephrotic proteinuria, without renal graft dysfunction, and this picture might explain late indication of graft biopsies. The 10-year patient survival rates were excellent.
authors.affiliation: Glomerulopathy Section, Department of Nephrology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: Ana Paula Pereira Santana
authors.initials: AP
authors.lastname: Lemes-Canuto
authors.affiliation: Renal Transplant, Unit of the Division of Nephrology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: Tainá Veras
authors.initials: TV
authors.lastname: de Sandes-Freitas
authors.affiliation: Renal Transplant, Unit of the Division of Nephrology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: José Osmar
authors.initials: JO
authors.lastname: Medina-Pestana
authors.affiliation: Glomerulopathy Section, Department of Nephrology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: Gianna
authors.initials: G
authors.lastname: Mastroianni-Kirsztajn
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: IgA nephropathy; Immunosuppression; Renal transplantation