Daijiworld Media Network - Copenhagen

Copenhagen, Jul 30: A Danish multicentre study has found that recurrent immunoglobulin A (IgA) nephropathy following kidney transplantation is associated with a significantly higher risk of kidney graft failure, with younger patients and those receiving kidneys from living or genetically related donors facing a greater likelihood of recurrence.

The study analysed data from 118 adults with biopsy-confirmed IgA nephropathy who underwent their first kidney-only transplant between 1990 and 2020 at two transplantation centres in Denmark. The patients were followed for a median period of 5.5 years to assess recurrence and post-transplant outcomes.

Researchers found that biopsy-confirmed recurrent IgA nephropathy occurred in 14 per cent of patients, with the cumulative incidence rising to 16 per cent 10 years after transplantation.

The study identified younger age at diagnosis of IgA nephropathy, faster progression to kidney failure and receiving a kidney from a living or genetically related donor as independent risk factors for recurrence.

The researchers also observed that the use of maintenance steroid therapy after transplantation was not associated with the risk of recurrence in the study population.

However, recurrent IgA nephropathy was strongly linked to poorer transplant outcomes. Patients with recurrent disease had a significantly higher risk of graft failure, with an unadjusted hazard ratio of 3.8 and an adjusted hazard ratio of 6.7 compared to those without recurrence.

The investigators concluded that recurrent IgA nephropathy remains a major clinical challenge after kidney transplantation and suggested that patient characteristics and donor-related factors could help identify individuals at greater risk.

They emphasised the need for larger and more diverse studies to better understand donor-related risks, evaluate immunosuppressive treatment strategies and develop approaches to improve long-term graft survival in patients with IgA nephropathy.