IMR Press / FBE / Volume 7 / Issue 1 / DOI: 10.2741/723

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review
Recurrent glomerular disease in the kidney allograft
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1 Renal Section, Department of Medicine, Boston University Medical Center, 650 Albany Street, Boston, MA

*Author to whom correspondence should be addressed.

Academic Editors: Ogo Egbuna, Jean Francis

Front. Biosci. (Elite Ed) 2015, 7(1), 155–170; https://doi.org/10.2741/723
Published: 1 January 2015
Abstract

Glomerulonephritis is responsible for nearly 15% of prevalent end-stage renal disease, and many of these patients will receive kidney transplants with the potential for a long duration of allograft survival. Recurrent glomerular disease, however, is not uncommon and can lead to both substantial morbidity and/or loss of the kidney allograft. The timing of recurrence after transplantation as well as the prevalence of recurrent disease vary by study, especially accounting for differences in protocol versus clinically-indicated biopsies, the use of immunofluorescence or electron microscopy in histopathological evaluation, and length of follow-up. Transplant immunosuppression alone may be sufficient to keep some recurrent disease in a subclinical form, whereas other recurrent glomerular diseases may be clinically evident and progress to threaten the allograft. This review highlights the epidemiology, diagnosis, and treatment of five common glomerular diseases that may recur in the transplant: focal and segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), immunoglobulin A nephropathy (IgAN), and lupus nephritis (LN).

Keywords
Kidney transplant
Recurrent glomerulonephritis
Focal and segmental glomerulosclerosis
Membranous nephropathy
Membranoproliferative glomerulonephritis
IgA nephropathy
Lupus nephritis
Review
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