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신이식 후 발생한 막성 사구체신염의 임상상

Other Titles
 Clinical Characteristics of Membranous Glomerulonephritis Developed after Renal Transplantation 
 길지훈  ;  이정은  ;  최훈영  ;  김범석  ;  강신욱  ;  최규헌  ;  이호영  ;  한대석  ;  김순일  ;  김유선 
 Journal of the Korean Society for Transplantation (대한이식학회지), Vol.19(2) : 163-169, 2005 
Journal Title
 Journal of the Korean Society for Transplantation (대한이식학회지) 
Issue Date
Purpose: Survival rate after renal transplantation has increased due to the development of new immunosuppressive agents and operative techniques. Therefore, chronic complications have increased. Membranous glomerulonephritis (MGN) is one of the common glomerular diseases diagnosed in transplanted kidneys. The exact impact of posttransplantation MGN on the risks for graft loss and long-term graft outcomes is not defined clearly. Risk factors to predict a poor outcome are not well established. Methods: The retrospective analysis was performed in 20 patients with posttransplantation MGN based on renal biopsy among 2,375 patients who underwent kidney transplantation in Shinchon Severance Hospital from April 1979 to December 2003. Results: After renal transplantation, five patients had de novo MGN and three patients had recurrent MGN. MGN was diagnosed by biopsy at 38.0+/-25.0 months after transplantation. (5~99 months) The duration of graft survival was 115.5+/-52.4 months. The lower was BUN level at 1 month after transplantation, the longer was the interval between renal transplantation and diagnosis of MGN. But donor age, dialysis duration, creatinine at diagnosis of MGN and immunosuppressive agents were not significantly related with the time from transplantation to diagnosis. In 10 cases, renal function was aggravated gradually and the other 10 cases, renal function remained stable. Graft loss occurred in 7 of 20 patients. Five of seven patients with graft loss transferred to peritoneal dialysis and the other 2 patients transferred to hemodialysis. Conclusion: De novo MGN and recurrent MGN can develop at any time after transplantation. Graft outcome is variable, with some patients progressing to graft failure, and others maintaining stable graft function. In conclusion, MGN after renal transplantation was more likely to occur in male. Aggressive evaluation such as renal biopsy will be needed when accompanied by hypertension and proteinuria. Renal function of de novo MGN will be maintained with proper immunosuppressive agents and conservative management.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
길지훈(Ghil, Jee Hoon)
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
이정은(Lee, Jung Eun) ORCID logo https://orcid.org/0000-0003-0917-2872
이호영(Lee, Ho Yung)
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
최훈영(Choi, Hoon Young) ORCID logo https://orcid.org/0000-0002-4245-0339
한대석(Han, Dae Suk)
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