title: Different Recurrence Rates Between Pediatric and Adult Renal Transplant for Immunoglobulin A Nephropathy: Predictors of Posttransplant Recurrence.
abstract: OBJECTIVE
  The purpose of this study was to investigate immunoglobulin A nephropathy recurrence rate after transplant in children and adults and to identify recurrence rates by clinical progression before transplant.
  
  
  METHODS
  There were 56 patients with immunoglobulin A nephropathy who had renal transplant between 1989 and 2005. We categorized recipient age into < or ≥ 20 years at transplant. Each age category was divided into 2 levels based on recurrence.
  
  
  RESULTS
  The recurrence rate was higher in patients aged < 20 years(53.8%) than ≥ 20 years. Proteinuria was more frequently diagnosed in patients aged < 20 years (57.1% vs 25.0%; P = .047). In patients aged ≥ 20 years, the duration of dialysis was 4.55 months in the recurrence group and 17.78 months in the no recurrence group (P = .032). Time from progressive symptoms to renal replacement therapy was significantly shorter in patients aged ≥ 20 years with recurrence than patients aged ≥ 20 years with no recurrence. The univariate relative risk of recurrent immunoglobulin A nephropathy after transplant was 9.8 for recipients aged ≥ 20 years who had progressive symptoms to renal replacement therapy < 24 months (P = .046).
  
  
  CONCLUSIONS
  Patients aged < 20 years had more rapid disease progression to end-stage renal disease and a higher recurrence rate after transplant than patients aged ≥ 20 years. If patients aged ≥ 20 years progress rapidly from progressive symptoms to renal replacement therapy, renal transplant may be considered after 24 months because of high recurrence risk.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sanghyun
authors.initials: S
authors.lastname: Ahn
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Min
authors.forename: Seung-Kee
authors.initials: SK
authors.lastname: Min
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Ha
authors.forename: Hee Gyung
authors.initials: HG
authors.lastname: Kang
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jongwon
authors.initials: J
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D018450:Disease Progression; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult