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International Journal of Nephrology
Volume 2018, Article ID 3720591, 6 pages
https://doi.org/10.1155/2018/3720591
Research Article

Clinical Presentation, Outcomes, and Treatment of Membranous Nephropathy after Transplantation

1Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
2Federal University of Ceará (UFC), Fortaleza, CE, Brazil

Correspondence should be addressed to Gianna Mastroianni-Kirsztajn; rb.moc.lou@kmannaig

Received 23 December 2017; Revised 20 May 2018; Accepted 12 June 2018; Published 5 July 2018

Academic Editor: Franca Anglani

Copyright © 2018 Artur Q. B. da Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are scarce data about clinical presentation and outcomes of posttransplant membranous nephropathy (MN), and few reports include a large number of patients. This was a retrospective cohort including adult patients with posttransplant MN transplanted between 1983 and 2015 in a single center (n=41). Only patients with histological diagnosis of MN in kidney grafts were included. Clinical and laboratory presentation, histological findings, treatment, and outcomes were detailed. Patients were predominantly male (58.5%), with a mean age of 49.4 ± 13.2 years; 15 were considered as recurrent primary MN; 3 were class V lupus nephritis; 14 were considered as de novo cases, 7 secondary and 7 primary MN; and 9 cases were considered primary but it was not possible to distinguish between de novo MN and recurrence. Main clinical presentations were proteinuria (75.6%) and graft dysfunction (34.1%). Most patients with primary recurrent and de novo primary MN were submitted to changes in maintenance immunosuppressive regimen, but no standard strategy was identified; 31 patients presented partial or complete remission, and glomerulopathy appeared not to impact graft and patient survival.