Table 3.
Disease | Presentation | Time of onset | Difference with native GN | Treatment | Prognosis |
MN | Proteinuria sometimes in nephrotic range | Late after transplant | Associated with trans-plant 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, or with other diseases | Steroids + cytotoxic drugs if crescentic GN (?) | Slowly progressive; poor with many crescents. |
FSGS | Proteinuria, rarely in nephrotic range | Months or years after transplant | NS is rare; signs of rejection or CNI toxicity at biopsy | Removal of associated events | Usually poor, particularly in collapsing GN |
MCD | NS | Early after transplant | Mild mesangial sclerosis, hypercellularity | Steroids | Good |
Adapted from: Ponticelli et al[14] (2014). De novo Glomerular Diseases after Renal Transplantation. Clin J Am Soc Nephrol 2014; 9: 1479-1487, with permission. MCD: Minimal change disease; NS: Nephrotic syndrome; MN: Membranous nephropathy; MPGN: Membranoproliferative GN; HCV: Hepatitis C virus.