Prediction of Recurrence and Graft Outcomes in Kidney Transplant Recipients with IgA Nephropathy: Role of Genetic and Oxidative Stress Markers

DİRİM A. B., Mirioglu Ş., OTO Ö. A., ARTAN A. S., ÖZLÜK M. Y., Hurdogan O., ...Daha Fazla

Turkish Journal of Nephrology, cilt.34, sa.2, ss.124-133, 2025 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.5152/turkjnephrol.2025.24885
  • Dergi Adı: Turkish Journal of Nephrology
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.124-133
  • Anahtar Kelimeler: biomarker, IgA nephropathy, kidney transplantation, oxidative stress, single nucleotide variants
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background: IgA nephropathy (IgAN) recurrence a"er kidney transplantation (KTx) could cause allogra" loss. New biomarkers are needed to assess the risk of IgAN recurrence and allogra" dysfunction following KTx. Methods: Thirty-seven KTx recipients who underwent KTx between 2002-2011 with biopsy-confirmed pre-transplant IgAN were evaluated in this retrospective study. Demographics, pathological and clinical/laboratory findings, and biomarkers, including levels of advanced oxidative protein products (AOPP) and galactose-deficient IgA1 and 4 tag single-nucleotide variants (tSNVs) associated with IgAN, were recorded. The primary outcome was IgAN recurrence. Biopsy-proven allogra" rejection (BPAR) and death-censored gra" failure (DCGF) were secondary outcomes. Results: 72.9% of patients were male. The mean age of KTx recipients was 37.4 ± 9.9 years. 45.9% of them experienced a recurrence of IgAN, during a median of 125 months of follow-up. There were more male donors in the recurrent IgAN group (P = .022). The median levels of UPCR were higher (P = .002) and estimated glomerular filtration rate (eGFR) were lower (P = .007) at the time of sampling in the recurrent group. Donor sex (male) (P = .018, HR: 3.853, 95% CI: 1.256-11.826) and eGFR at sampling (P = .039, HR: 0.967, 95% CI: 0.937-0.998) were predictors of IgAN recurrence in Cox regression analysis. Advanced oxidative protein products (median 78.4 vs 67.35 (#mol/L)) and Gd-IgA1 (median 5390.3 vs 4732.5 ng/#L) levels were insignificantly elevated in the patients with IgAN recurrence. Statistical di$erences were not present in terms of secondary outcomes between the patients with and without IgAN recurrence. Single-nucleotide variants were not statistically associated with the recurrence of IgAN. Conclusions: Prospective biomarker/genetic marker studies, including large patient cohorts, are required to evaluate the risk of IgAN recurrence and allogra" function a"er KTx.