| Objective:To investigate the clinical characteristics,pathological types and related risk factors of transplanted renal nephropathy after renal transplantation,and to provide a theoretical basis for early diagnosis and treatment.Methods:The clinical and pathological data of patients who underwent renal graft biopsy in the First Hospital of Jilin University from August 2011 to January 2021 were retrospectively analyzed.All the pathological results were completed by the Pathology Department of Transplantation of the First Hospital of Jilin University.According to the occurrence of renal transplantation and the source of donor kidney,the donor kidney was divided into four groups:the relative control group（16 cases,including 7males and 9 females）.There were 42 patients in the relative donor kidney transplantation renal nephropathy group,including 32 males and 10females.Thirty-nine patients（21 males and 18 females）were included in the control group（DD）after the death of citizens,including 21 males and18 females;There were 63 patients in the DD donor kidney transplantation renal nephropathy group（DD nephropathy group）,including 40 males and 23 females.The general situation,postoperative follow-up data and survival rate of kidney transplantation at 1,3 and 5years were analyzed.Univariate analysis of patients’clinical data was conducted according to data type,and results with P<0.1 were included in binary Logistic regression analysis to determine the risk factors of renal transplantation.Results:1.In a relative kidney transplant:There were 33 cases of Ig A nephropathy,5 cases of membranous nephropathy,3 cases of focal segmental glomerulosclerosis,and 1 case of membranous proliferative nephropathy;Albuminuria and occult blood were more serious in the relative nephropathy group than in the relative control group（all P<0.05）;The risk of renal transplantation was 9.99（95%CI 1.64-60.87）times higher in patients with hypertension than in patients without hypertension;The 5-year survival rate was 100%in the relative control group,which was significantly better than the 1-year,3-year,5-year survival rate of 92%,88%,and 81%in the relative control group（P<0.05）;Recipient gender,age,BMI,history of diabetes,duration of dialysis,preoperative induction regimen,first-line and second-line immunosuppressants,urea nitrogen,cold ischemia time,heat ischemia time,Human Leukocyte Antigen,There were no significant differences in HLA mismatch,acute rejection,and Delayed Graft Function（DGF）history and the sex,age and BMI of the donor between the relative nephropathy group and the relative control group（all P>0.05）.2.In DD kidney transplantation:The types of nephropathy were Ig A nephropathy 51 cases,membranous nephropathy 1 case,focal segmental glomerulosclerosis 9 cases,membranous proliferative nephropathy 1 case,purpura nephropathy 1 case;Proteinuria,occult blood,creatinine and e GFR were more serious in DD nephropathy group than in DD control group（all P<0.05）;The risk of kidney disease in DD recipients increased 1.73（95%CI 1.22-2.46）times with each increase in BMI of1kg/m~2.The risk of kidney disease in DD patients with hypertension was71.11（95%CI 8.01-631.55）times higher than that in DD patients without hypertension;The risk of kidney disease in DD recipients with a history of acute rejection was 20.79（95%CI 1.21-356.97）times higher than that in DD recipients without a history of acute rejection;The 1-year,3-year and 5-year survival rates were 100%,92%and 92%in DD control group and 100%,91%and 91%in DD nephropathy group（P>0.05）;There were no significant differences between DD nephropathy group and DD control group in gender,age,diabetes history,duration of dialysis,preoperative induction program,first-line and second-line immunosuppressive agents,urea nitrogen,cold ischemia time,hot ischemia time,HLA mismatch,DGF history,donor gender,age,BMI and other factors（all P>0.05）.Conclusions:1.The history of hypertension was a risk factor for renal nephropathy after relative kidney transplantation.2.History of hypertension,recipient BMI and history of acute rejection were risk factors for renal nephropathy in DD donor kidney transplantation.3.The levels of occult blood and urine protein were significantly higher in the recipients of transplanted kidney disease than in the control group（P<0.001）.4.Relative donor kidney transplantation renal nephropathy significantly reduced the graft survival rate（P=0.001）,and the 1-year,3-year and 5-year survival rates were 92%,88%and 81%,respectively.5.Common graft nephropathy includes Ig A nephropathy,focal segmental glomerulosclerosis,membranous nephropathy,and membranous proliferative nephropathy. |
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