Recurrent lupus nephritis after kidney transplantation: a surveillance biopsy study. Issue 8 (24th May 2010)

• Record Type: Journal Article
• Authors: Norby, Gudrun E; Strøm, Erik H; Midtvedt, Karsten; Hartmann, Anders; Gilboe, Inge-Margrethe; Leivestad, Torbjørn; Stenstrøm, Jean; Holdaas, Hallvard
• Is Part Of: Annals of the rheumatic diseases. Volume 69:Issue 8(2010)
• Page Start: 1484
• Page End: 1487
• Publication Date: 2010-05-24
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2009.122796
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To determine the incidence of recurrent lupus nephritis (LN) in renal transplant recipients with systemic lupus erythematosus (SLE). Methods: All patients with SLE that had undergone transplant with a functioning graft were asked in 2008 to participate in a cross-sectional study. The study included a standardised clinical examination, laboratory tests and a biopsy of the transplanted kidney. Results: A total of 41 (93%) of a cohort of 44 patients with SLE with renal transplants participated. Of the biopsies, 3 were indication biopsies and 38 were surveillance biopsies. In all, 22 patients (54%) had biopsy-proven recurrence of LN. The majority of the cases were subclinical and characterised as class I/class II LN. Proteinuria (mg protein/mmol creatinine) was significantly increased in patients with recurrence, 70.6 (104.9) mg/mmol versus 11.9 (6.7) mg/mmol in patients without recurrence (p=0.038). Lupus anticoagulant was found more frequently in the patients with recurrence, nine versus two patients (p=0.033). Recurrence of LN was associated with receiving a kidney from a living donor (p=0.049). In all, 83% (34 of 41) had chronic allograft nephropathy in the transplanted kidneys with no difference between patients with recurrence or without. Conclusions: Subclinical recurrence of LN is common in patients with renal transplants with SLE. The majority of the patients have chronic allograft nephropathy.