Graft Dysfunction due to Immunoglobulin A Nephropathy in the 1st Week after Renal Transplantation

Abstract

Immunoglobulin A (IgA) nephropathy is the most common primary glomerular disease worldwide, with a quarter to half of the patients reaching end-stage renal failure in a decade or two. Patients with end-stage kidney disease due to IgA nephropathy who undergo renal transplantation are found to have recurrence of IgA deposits in renal mesangium in the posttransplant protocol renal biopsies without evidence of clinical recurrence. A few case reports have documented early occurrence of proteinuria, hematuria, and mild graft dysfunction in the early posttransplant period, but severe renal failure in the 1 ^st week requiring renal replacement therapy has not been reported, to the best of our knowledge. This is the case of a 43-year-old female with IgA nephropathy who underwent an ABO-compatible sibling donor renal transplantation with no human leukocyte antigen mismatch. She developed dialysis requiring severe renal failure in the 1 ^st week after renal transplantation, and graft biopsy revealed IgA nephropathy.