Topic:	Kidney and Urologic Diseases (KU)
Title:	Recurrent Lupus Nephritis in Renal Transplant Recipients Revisited: It Is Not Rare.
Author:	Goral, S., et al.
Source:	Transplantation. 75(5): 651-656. March 2003.
Abstract:	Although recurrent lupus nephritis (RLN) after kidney transplantation is reported to be rare (1 to 4 percent), recent studies suggest a higher incidence. This article reports on a study undertaken to determine the incidence of RLN in a large cohort of renal transplant recipients with systemic lupus erythematosus (SLE). The records of 54 renal transplant recipients with SLE were reviewed; 31 patients underwent biopsy because of worsening renal function and proteinuria. Among the 50 patients with at least 3 months of follow up, RLN was present in 15 (52 percent of patients who underwent biopsy, 30 percent of total patients): mesangial lupus nephritis (LN) in eight patients, focal proliferative LN in four, and membranous LN in three patients. One patient had graft loss because of RLN at 10.5 years. The duration of dialysis before transplantation was not different between patients with RLN compared to patients without RLN. Overall patient survival (n = 50) was 96 percent at 1 year and 82 percent at 5 years. Graft survival was worse in patients who underwent biopsy compared with patients who never underwent biopsy. The authors conclude that RLN is more common than previously reported, but in this series, graft loss because of RLN was rare. Aggressive use of allograft biopsies and morphological evaluation are important factors in the diagnosis of RLN. 2 figures. 2 tables. 29 references.
Format:	Journal Article
Language:	English.
Major Keywords:	Kidney Diseases. Nephritis. Chronic Disease. Recurrence. Transplantation. Kidney. Incidence. Rejection. Lupus Erythematosus.
Minor Keywords:	Risk Factors. Patient Care Management. Patient Selection. Mortality. Morbidity. Biopsy. Monitoring. Diagnostic Tests. Proteinuria.
Publication Number:	KUJA11118
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