Lupus Patients Who Receive Kidney Transplants Rarely Develop Lupus Nephritis

Recurrent lupus nephritis is uncommon in lupus patients who receive a kidney transplant, but the condition often leads to allograft failure with an increased risk of death after transplantation. That was the finding of a study presented recently at Renal Week.

Studies have provided conflicting results about the incidence and severity of the inflammatory condition lupus nephritis in patients with a history of lupus who have received a kidney transplant. To study the issue, Gabriel Contreras, MD, of the University of Miami, and his colleagues analyzed data from the United Network for Organ Sharing to determine the frequency of lupus nephritis in kidney transplant recipients and the risk this condition has for patients. Their analysis included 6850 patients with a history of lupus who received kidney transplants between 1987 and 2006.

The researchers found that lupus nephritis occurred in 2.44 percent of individuals in the study and that it led to a fourfold increased risk of kidney transplant failure. Also, death occurred in approximately 16 percent of affected transplant recipients.

“Lupus recurring in the kidney transplant as an event is less important than rejection in determining the absolute risk of kidney transplant failure because rejection is a much more frequent event, occurring in 26 percent of the recipients,” said Contreras.

The investigators discovered that African Americans [odds ratio (OR) = 1.71; 95 percent confidence interval (CI) = 1.25–2.34) and young women (OR = 1.69; 95 percent CI = 1.05–2.75) were at higher risk for developing lupus nephritis in their transplanted kidney, but receiving a kidney transplant before or after starting dialysis did not affect one’s risk. The type of kidney transplant (deceased or living donor) also had no effect on a patient’s risk of developing lupus nephritis.

The study, “Recurrence of Lupus Nephritis Following Kidney Transplantation,” was presented as part of a Renal Week session on Transplantation: Epidemiology, Outcomes, Clinical Trials, and Health Services Research.