RESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Lesión Renal Aguda/terapia , Hipoalbuminemia/prevención & control , Cadenas kappa de Inmunoglobulina/análisis , Túbulos Renales/química , Membranas Artificiales , Mieloma Múltiple/complicaciones , Proteínas de Mieloma/análisis , Diálisis Renal/métodos , Lesión Renal Aguda/sangre , Lesión Renal Aguda/etiología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bortezomib/administración & dosificación , Dexametasona/administración & dosificación , Cadenas kappa de Inmunoglobulina/sangre , Riñones Artificiales , Mieloma Múltiple/sangre , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/tratamiento farmacológico , Diálisis Renal/instrumentación , Albúmina Sérica/análisisRESUMEN
IgA nephropathy (IgAN) recurrence in the renal graft is variable. Several factors can influence the risk of recurrence of IgAN and renal graft failure. We carried out a retrospective observational study between the years 1990 and 2018. The study group was patients diagnosed, by means of biopsy, as having post-renal transplant (RT) IgAN in our hospital in the study period. The control group was patients with pre-RT histologic diagnosis of IgAN who did not develop recurrence of the disease after the RT. A total of 1535 RTs were performed in our center in the study period. Of those, 24 patients developed IgAN in the renal graft. The time elapsed from the RT to the development of allograft IgAN was 7 (SD, 5.3) years. The patients with allograft IgAN tended to be younger (P = .069), and HLA-DR4 was more common in these patients (P = .078). We observed a very significant difference in the use of induction immunosuppressive therapy (study group vs control group: 13.6% vs 57.7%, P < .001). The 3 patients who presented crescents in the biopsy specimen lost the renal graft. As in the native kidney, the presence of crescents is an indicator of poor prognosis. In our experience, the patients with post-RT IgAN received induction therapy less frequently; this finding would support the conclusion that such treatments should be applied to patients with pre-RT diagnosis of IgAN.
Asunto(s)
Glomerulonefritis por IGA/inmunología , Terapia de Inmunosupresión/efectos adversos , Trasplante de Riñón/efectos adversos , Complicaciones Posoperatorias/inmunología , Adulto , Aloinjertos/inmunología , Aloinjertos/patología , Biopsia , Femenino , Supervivencia de Injerto , Humanos , Terapia de Inmunosupresión/métodos , Inmunosupresores/efectos adversos , Riñón/inmunología , Riñón/patología , Masculino , Persona de Mediana Edad , Recurrencia , Estudios RetrospectivosAsunto(s)
Lesión Renal Aguda/terapia , Hipoalbuminemia/prevención & control , Cadenas kappa de Inmunoglobulina/análisis , Túbulos Renales/química , Membranas Artificiales , Mieloma Múltiple/complicaciones , Proteínas de Mieloma/análisis , Diálisis Renal/métodos , Lesión Renal Aguda/sangre , Lesión Renal Aguda/etiología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bortezomib/administración & dosificación , Dexametasona/administración & dosificación , Femenino , Humanos , Cadenas kappa de Inmunoglobulina/sangre , Riñones Artificiales , Masculino , Persona de Mediana Edad , Mieloma Múltiple/sangre , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/tratamiento farmacológico , Diálisis Renal/instrumentación , Albúmina Sérica/análisisRESUMEN
BACKGROUND: Chronic graft nephropathy is the most frequent cause of long-term renal transplant loss. Although immunological causes participate in its pathogenesis, other non-immunological factors such as hyperfiltration due to reduced renal mass have been proposed as causal factors of chronic renal graft nephropathy. AIM: This study aimed to assess the effect of weight disproportion between the donor and recipient in the development of chronic renal graft nephropathy. METHODS: Three weight categories for donors and recipients were established: < 50, 50-75 and > 75 kg. Three groups were distinguished according to the three possible weight combinations between donor and recipient: donor weight (DW)>recipient weight (RW) (N = 133), DW = RW (N = 255) and DWAsunto(s)
Peso Corporal
, Enfermedades Renales/etiología
, Trasplante de Riñón/efectos adversos
, Donantes de Tejidos
, Adulto
, Enfermedad Crónica
, Femenino
, Supervivencia de Injerto
, Humanos
, Trasplante de Riñón/mortalidad
, Masculino
, Análisis por Apareamiento
, Persona de Mediana Edad
, Tasa de Supervivencia
, Factores de Tiempo