Table 1.
Disease | Presentation | Time of Onset | Difference with Native GN | Treatment | Prognosis |
---|---|---|---|---|---|
MCD | NS | Early after transplant | Mild mesangial sclerosis, hypercellularity | Steroids | Good |
FSGS | Proteinuria, rarely in nephrotic range | Months or years after transplant | NS is rare; signs of rejection or calcineurin inhibitor toxicity at biopsy | Removal of associated events | Usually poor, particularly in collapsing GN |
MN | Proteinuria sometimes in nephrotic range | Late after transplant | Associated with transplant complications; IgG1 deposits instead of IgG4 | No specific treatment | Slowly progressive |
MPGN | Proteinuria, hematuria, NS, nephritic sediment | Months or years after transplant | Often associated with HCV infection, sometimes with other diseases | Steroids+cytotoxic drugs if crescentic GN (?) | Slowly progressive; poor with many crescents |
IgAN | Hematuria, proteinuria | Macroscopic hematuria is infrequent | Steroids+cytotoxic drugs if crescentic GN (?) | Usually good but poor in patients with crescentic GN |
MCD, minimal change disease; NS, nephrotic syndrome; MN, membranous nephropathy; MPGN, membranoproliferative GN; HCV, hepatitis C virus; IgAN, IgA nephritis.