Recurrent and de novo Glomerulonephritis After Kidney Transplantation

Wai H. Lim, Meena Shingde, Germaine Wong

Research output: Contribution to journalReview article

Abstract

The prevalence, pathogenesis, predictors, and natural course of patients with recurrent glomerulonephritis (GN) occurring after kidney transplantation remains incompletely understood, including whether there are differences in the outcomes and advances in the treatment options of specific GN subtypes, including those with de novo GN. Consequently, the treatment options and approaches to recurrent disease are largely extrapolated from the general population, with responses to these treatments in those with recurrent or de novo GN post-transplantation poorly described. Given a greater understanding of the pathogenesis of GN and the development of novel treatment options, it is conceivable that these advances will result in an improved structure in the future management of patients with recurrent or de novo GN. This review focuses on the incidence, genetics, characteristics, clinical course, and risk of allograft failure of patients with recurrent or de novo GN after kidney transplantation, ascertaining potential disparities between "high risk" disease subtypes of IgA nephropathy, idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis. We will examine in detail the management of patients with high risk GN, including the pre-transplant assessment, post-transplant monitoring, and the available treatment options for disease recurrence. Given the relative paucity of data of patients with recurrent and de novo GN after kidney transplantation, a global effort in collecting comprehensive in-depth data of patients with recurrent and de novo GN as well as novel trial design to test the efficacy of specific treatment strategy in large scale multicenter randomized controlled trials are essential to address the knowledge deficiency in this disease.

Original languageEnglish
Article number1944
Number of pages20
JournalFrontiers in Immunology
Volume10
DOIs
Publication statusPublished - 14 Aug 2019

Cite this

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title = "Recurrent and de novo Glomerulonephritis After Kidney Transplantation",
abstract = "The prevalence, pathogenesis, predictors, and natural course of patients with recurrent glomerulonephritis (GN) occurring after kidney transplantation remains incompletely understood, including whether there are differences in the outcomes and advances in the treatment options of specific GN subtypes, including those with de novo GN. Consequently, the treatment options and approaches to recurrent disease are largely extrapolated from the general population, with responses to these treatments in those with recurrent or de novo GN post-transplantation poorly described. Given a greater understanding of the pathogenesis of GN and the development of novel treatment options, it is conceivable that these advances will result in an improved structure in the future management of patients with recurrent or de novo GN. This review focuses on the incidence, genetics, characteristics, clinical course, and risk of allograft failure of patients with recurrent or de novo GN after kidney transplantation, ascertaining potential disparities between {"}high risk{"} disease subtypes of IgA nephropathy, idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis. We will examine in detail the management of patients with high risk GN, including the pre-transplant assessment, post-transplant monitoring, and the available treatment options for disease recurrence. Given the relative paucity of data of patients with recurrent and de novo GN after kidney transplantation, a global effort in collecting comprehensive in-depth data of patients with recurrent and de novo GN as well as novel trial design to test the efficacy of specific treatment strategy in large scale multicenter randomized controlled trials are essential to address the knowledge deficiency in this disease.",
keywords = "recurrent disease, glomerulonephritis, kidney transplantation, recurrent glomerulonephritis, de novo glomerulonephritis, allograft failure, FOCAL SEGMENTAL GLOMERULOSCLEROSIS, IDIOPATHIC MEMBRANOUS NEPHROPATHY, PHOSPHOLIPASE A(2) RECEPTOR, ANCA-ASSOCIATED VASCULITIS, HEMOLYTIC-UREMIC SYNDROME, MONOCLONAL IGG DEPOSITS, I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS, POSTTRANSPLANT NEPHROTIC SYNDROME, MINIMAL CHANGE DISEASE, RENAL-TRANSPLANTATION",
author = "Lim, {Wai H.} and Meena Shingde and Germaine Wong",
year = "2019",
month = "8",
day = "14",
doi = "10.3389/fimmu.2019.01944",
language = "English",
volume = "10",
journal = "Frontiers in Immunology",
issn = "1664-3224",
publisher = "Frontiers Media SA",

}

Recurrent and de novo Glomerulonephritis After Kidney Transplantation. / Lim, Wai H.; Shingde, Meena; Wong, Germaine.

In: Frontiers in Immunology, Vol. 10, 1944, 14.08.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Recurrent and de novo Glomerulonephritis After Kidney Transplantation

AU - Lim, Wai H.

AU - Shingde, Meena

AU - Wong, Germaine

PY - 2019/8/14

Y1 - 2019/8/14

N2 - The prevalence, pathogenesis, predictors, and natural course of patients with recurrent glomerulonephritis (GN) occurring after kidney transplantation remains incompletely understood, including whether there are differences in the outcomes and advances in the treatment options of specific GN subtypes, including those with de novo GN. Consequently, the treatment options and approaches to recurrent disease are largely extrapolated from the general population, with responses to these treatments in those with recurrent or de novo GN post-transplantation poorly described. Given a greater understanding of the pathogenesis of GN and the development of novel treatment options, it is conceivable that these advances will result in an improved structure in the future management of patients with recurrent or de novo GN. This review focuses on the incidence, genetics, characteristics, clinical course, and risk of allograft failure of patients with recurrent or de novo GN after kidney transplantation, ascertaining potential disparities between "high risk" disease subtypes of IgA nephropathy, idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis. We will examine in detail the management of patients with high risk GN, including the pre-transplant assessment, post-transplant monitoring, and the available treatment options for disease recurrence. Given the relative paucity of data of patients with recurrent and de novo GN after kidney transplantation, a global effort in collecting comprehensive in-depth data of patients with recurrent and de novo GN as well as novel trial design to test the efficacy of specific treatment strategy in large scale multicenter randomized controlled trials are essential to address the knowledge deficiency in this disease.

AB - The prevalence, pathogenesis, predictors, and natural course of patients with recurrent glomerulonephritis (GN) occurring after kidney transplantation remains incompletely understood, including whether there are differences in the outcomes and advances in the treatment options of specific GN subtypes, including those with de novo GN. Consequently, the treatment options and approaches to recurrent disease are largely extrapolated from the general population, with responses to these treatments in those with recurrent or de novo GN post-transplantation poorly described. Given a greater understanding of the pathogenesis of GN and the development of novel treatment options, it is conceivable that these advances will result in an improved structure in the future management of patients with recurrent or de novo GN. This review focuses on the incidence, genetics, characteristics, clinical course, and risk of allograft failure of patients with recurrent or de novo GN after kidney transplantation, ascertaining potential disparities between "high risk" disease subtypes of IgA nephropathy, idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis. We will examine in detail the management of patients with high risk GN, including the pre-transplant assessment, post-transplant monitoring, and the available treatment options for disease recurrence. Given the relative paucity of data of patients with recurrent and de novo GN after kidney transplantation, a global effort in collecting comprehensive in-depth data of patients with recurrent and de novo GN as well as novel trial design to test the efficacy of specific treatment strategy in large scale multicenter randomized controlled trials are essential to address the knowledge deficiency in this disease.

KW - recurrent disease

KW - glomerulonephritis

KW - kidney transplantation

KW - recurrent glomerulonephritis

KW - de novo glomerulonephritis

KW - allograft failure

KW - FOCAL SEGMENTAL GLOMERULOSCLEROSIS

KW - IDIOPATHIC MEMBRANOUS NEPHROPATHY

KW - PHOSPHOLIPASE A(2) RECEPTOR

KW - ANCA-ASSOCIATED VASCULITIS

KW - HEMOLYTIC-UREMIC SYNDROME

KW - MONOCLONAL IGG DEPOSITS

KW - I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS

KW - POSTTRANSPLANT NEPHROTIC SYNDROME

KW - MINIMAL CHANGE DISEASE

KW - RENAL-TRANSPLANTATION

U2 - 10.3389/fimmu.2019.01944

DO - 10.3389/fimmu.2019.01944

M3 - Review article

VL - 10

JO - Frontiers in Immunology

JF - Frontiers in Immunology

SN - 1664-3224

M1 - 1944

ER -