Recurrent Glomerulonephritis After Kidney Transplantation

Abstract

Introduction: Recurrent glomerulonephritis (GN) causes 20% of late graft failures. Methods: Review of 30 studies on incidence and outcomes of recurrent primary GN (IgA nephropathy, FSGS, membranous, MPGN). Results: Recurrence rates: FSGS 30–50%, IgA 20–40%, membranous 10–30%. Post-transplant recurrence of FSGS leads to graft loss in 50% by 5 years. Plasmapheresis for FSGS achieved remission in 60% if started early. Rituximab for membranous recurrence showed 70% response. Discussion: Monitoring proteinuria and allograft biopsy for high-risk patients is essential. Conclusion: Pretransplant risk stratification and post-transplant surveillance improve outcomes.