Does Nephritis Relapse after a Kidney Transplant

In China, 70 percent end-stage renal disease results from glomerulonephritis. Apart from the hereditary nephritis syndrome, polycystic kidney disease (PKD), chronic nephropyelitis and chronic interstitial glomerulonephritis, almost all types of kidney disease could relapse after a kidney transplant. But there is no need to worry too much. Less than 5 percent transplanted kidneys are lost. Here are the types of kidney disease which are likely to relapse.

FSGS (focal segmental glomerulosclerosis). It has a high relapse rate in people with severe clinical manifestations. Approximate 50 percent will relapse after a kidney transplant.

IgA nephropathy. It has a much higher relapse rate after a kidney transplant. 80 percent patients suffer from the deposition of IgA in the mesangial region. The clinical manifestations are rare and less than 10% transplanted kidneys are lost.

Crescent nephropathy. Although there are successful cases in patients with positive glomerular basement membrane antibody, kidney transplant is performed after the antibody disappears in order to reduce the relapse rate.

Secondary glomerular nephritis. Kidney transplant is performed after all the indicators such as C3 and C4 are normal with small amount of glucocorticoid. Routine biopsy shows that the relapse rate in histology is as high as 35% but the clinical relapse is only 1%. More important, SLE patients are likely to develop phlebothrobosis and arterial thrombus.

Purpura nephritis. It relapse in patients who had the active purpura 8 months before kidney transplant. The relapse rate is as high as 75 percent but the maninfasation relapse rate is low.
Generally, consider it seriously if the relapse rate is higher.