Volume 10 Issue 1
Jan.  2019
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Huang Yuanhang, Fan Liming, Deng Suxiong, et al. Analysis of survival and influencing factors of patients with recurrent and de novo nephritis of renal allograft[J]. ORGAN TRANSPLANTATION, 2019, 10(1): 67-73. doi: 10.3969/j.issn.1674-7445.2019.01.010
Citation: Huang Yuanhang, Fan Liming, Deng Suxiong, et al. Analysis of survival and influencing factors of patients with recurrent and de novo nephritis of renal allograft[J]. ORGAN TRANSPLANTATION, 2019, 10(1): 67-73. doi: 10.3969/j.issn.1674-7445.2019.01.010
shu

Analysis of survival and influencing factors of patients with recurrent and de novo nephritis of renal allograft

doi: 10.3969/j.issn.1674-7445.2019.01.010

  • Department of Nephrology, General Hospital of Southern Theater of Chinese People's Liberation Army, Guangzhou 510010, China

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  • Corresponding author: Fan Liming, Email: flm0102@126.com
  • Received Date: 2018-10-13
    Available Online: 2021-01-19
  • Publish Date: 2019-01-15
    Abstract
  •   Objective  To analyze the survival and influencing factors of patients with recurrent and de novo nephritis of the renal allograft.  Methods  Clinical data of 95 patients undergoing pathological puncture (biopsy) of the renal allograft were retrospectively analyzed. According to the biopsy results, all recipients were assigned into the recurrent group (n=28), de novo group(n=33) and non-nephritis group (n=34). The 1-, 3- and 5-year survival was statistically analyzed and the survival rates were calculated in three groups. Kaplan-Meier survival curve was adopted to analyze the 5-year survival. Clinical data of patients with recurrent and de novo nephritis were analyzed by univariate analysis. Logistic regression analysis was utilized to analyze the influencing factors of clinical prognosis of patients with recurrent and de novo nephritis.  Results  The 1-year survival rate did not significantly differ among three groups (all P > 0.05). The 3-year survival rates in the de novo group and non-nephritis group were 97% and 100%, significantly higher than 86% in the recurrent group (both P < 0.05). The 5-year survival rates in the de novo group and non-nephritis group were 82% and 91%, considerably higher than 61% in the recurrent group (both P < 0.05). Logistic regression analysis demonstrated that the survival rate of patients with recurrent renal nephritis was significantly correlated with the times of renal transplantation, cold ischemia time (≥12 h), immunosuppressive regime, recovery time of postoperative serum creatinine (Scr) (≥14 d), complications at postoperative 1 month (acute renal tubular necrosis, ultra-acute rejection and acute rejection) and type of nephritis (IgA nephropathy, focal segmental glomerular sclerosis and hemolytic-uremic syndrome) (all P < 0.05). In patients with de novo nephritis, the survival rate was significantly associated with cold ischemia time (≥12 h), immunosuppressive regime, recovery time of postoperative Scr (≥14 d) and complications at postoperative 1 month (acute renal tubular necrosis, ultra-acute rejection and acute rejection) (all P < 0.05).  Conclusions  The survival rate of patients with recurrent renal nephritis is lower than those in their counterparts with de novo nephritis and without nephritis. Cold ischemia time, immunosuppressive regime, recovery time of postoperative Scr and complications at postoperative 1 month are pivotal influencing factors of the clinical prognosis of patients with recurrent and de novo nephritis of the renal allograft.

     

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