Tubulo-interstitial inflammation increases the risk of graft loss after the recurrence of IgA nephropathy

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  • dc.contributor.author Rodrigo Calabia, Emilio
  • dc.contributor.author Quintana, Luis
  • dc.contributor.author Vázquez Sánchez, Teresa
  • dc.contributor.author Sánchez Fructuoso, Ana
  • dc.contributor.author Buxeda, Anna
  • dc.contributor.author Gavela, Eva
  • dc.contributor.author Cazorla, Juan M.
  • dc.contributor.author Cabello, Sheila
  • dc.contributor.author Beneyto, Maria Isabel
  • dc.contributor.author López-Oliva, Maria O.
  • dc.contributor.author Diekmann, Fritz
  • dc.contributor.author Gómez Ortega, José M.
  • dc.contributor.author Calvo Romero, Natividad
  • dc.contributor.author Pérez-Sáez, María José
  • dc.contributor.author Sancho, Asunción
  • dc.contributor.author Mazuecos, Auxiliadora
  • dc.contributor.author Espí Reig, Jordi
  • dc.contributor.author Jiménez, Carlos
  • dc.contributor.author Hernández, Domingo
  • dc.date.accessioned 2024-10-09T06:25:06Z
  • dc.date.available 2024-10-09T06:25:06Z
  • dc.date.issued 2023
  • dc.description.abstract Background: Immunoglobulin A nephropathy (IgAN) is the most frequent recurrent disease in kidney transplant recipients and its recurrence contributes to reducing graft survival. Several variables at the time of recurrence have been associated with a higher risk of graft loss. The presence of clinical or subclinical inflammation has been associated with a higher risk of kidney graft loss, but it is not precisely known how it influences the outcome of patients with recurrent IgAN. Methods: We performed a multicentre retrospective study including kidney transplant recipients with biopsy-proven recurrence of IgAN in which Banff and Oxford classification scores were available. 'Tubulo-interstitial inflammation' (TII) was defined when 't' or 'i' were ≥2. The main endpoint was progression to chronic kidney disease (CKD) stage 5 or to death censored-graft loss (CKD5/DCGL). Results: A total of 119 kidney transplant recipients with IgAN recurrence were included and 23 of them showed TII. Median follow-up was 102.9 months and 39 (32.8%) patients reached CKD5/DCGL. TII related to a higher risk of CKD5/DCGL (3 years 18.0% vs 45.3%, log-rank 7.588, P = .006). After multivariate analysis, TII remained related to the risk of CKD5/DCGL (HR 2.344, 95% CI 1.119-4.910, P = .024) independently of other histologic and clinical variables. Conclusions: In kidney transplant recipients with IgAN recurrence, TII contributes to increasing the risk of CKD5/DCGL independently of previously well-known variables. We suggest adding TII along with the Oxford classification to the clinical variables to identify recurrent IgAN patients at increased risk of graft loss who might benefit from intensified immunosuppression or specific IgAN therapies.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Rodrigo E, Quintana LF, Vázquez-Sánchez T, Sánchez-Fructuoso A, Buxeda A, Gavela E, et al. Tubulo-interstitial inflammation increases the risk of graft loss after the recurrence of IgA nephropathy. Clin Kidney J. 2023 Oct 16;17(1):sfad259. DOI: 10.1093/ckj/sfad259
  • dc.identifier.doi http://dx.doi.org/10.1093/ckj/sfad259
  • dc.identifier.issn 2048-8505
  • dc.identifier.uri http://hdl.handle.net/10230/61359
  • dc.language.iso eng
  • dc.publisher Oxford University Press
  • dc.relation.ispartof Clin Kidney J. 2023 Oct 16;17(1):sfad259
  • dc.rights © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.subject.keyword IgA nephropathy
  • dc.subject.keyword Graft loss
  • dc.subject.keyword Inflammation
  • dc.subject.keyword Kidney transplantation
  • dc.subject.keyword Recurrence
  • dc.title Tubulo-interstitial inflammation increases the risk of graft loss after the recurrence of IgA nephropathy
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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Articles (Hospital del Mar Research Institute)