Recurrence of IgA Nephropathy in Protocol Kidney Biopsies After Renal Transplantation and Its Impact on Prognosis

Objectives: IgA nephropathy (IgAN) is a common primary glomerulonephritis with a wide clinical spectrum ranging from asymptomatic urinary abnormalities to rapidly progressive disease and is a major cause of chronic kidney failure. Although kidney transplantation is an effective treatment for primary IgAN, recurrence and graft loss remain significant concerns.
Methods: This study investigated predictors of post-transplant IgAN recurrence and graft loss. Seventy-six patients who underwent kidney transplantation due to end-stage kidney disease secondary to primary IgAN were retrospectively analyzed. First-year protocol biopsy results (6-month and 12-month) were evaluated using light microscopy and immu-nofluorescence. Baseline demographic, clinical, and laboratory data, along with post-transplant parameters, indication biopsies after the first year, graft loss, and mortality were analyzed.
Results: Binary logistic regression was used to identify predictors of recurrence, and Kaplan–Meier analysis assessed graft survival. Group comparisons were performed using appropriate statistical tests, with p<0.05 considered significant. Conclusion: Recurrence rates were 9.3% at 6 months and 26.3% at 12 months. Isolated IgA deposition detected by immunofluorescence was common. Age at transplantation was independently associated with recurrence; each ad-ditional year reduced risk by 6%. No association was found between recurrence and 10-year graft survival. Younger age was strongly associated with recurrence.

Keywords: Biopsy, IgA nephropathy, kidney transplantation, prognosis, recurrence