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New research · Nephrology
Clinical transplantation · 16h
Cohort studyClinical transplantation · 2026

Graft Outcomes in For-Cause Biopsy-Proven Recurrent IgA Nephropathy After Kidney Transplantation: Rare but Clinically Meaningful.

Pitchamon Inkong, Erik L Lum, Kara Kim … Suphamai Bunnapradist
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NephrologyCohort study

IFTA >50% at recurrence linked to worse graft survival in recurrent IgA nephropathy

Graft Outcomes in For-Cause Biopsy-Proven Recurrent IgA Nephropathy After Kidney Transplantation: Rare but Clinically Meaningful.

Pitchamon Inkong et al. · Clinical transplantation · 2026
Background

Recurrent IgA nephropathy (IgAN) after kidney transplantation has been reported in up to 20%-60% of recipients, through incidence varies by surveillance strategy.

Purpose

We aimed to define the incidence and clinical impact of biopsy-proven recurrence IgAN in a single center cohort.

Methods

We performed retrospective review of renal allograft biopsies performed at UCLA between 2020 and 2025.

n = 1474 patients
Results

Severe kidney scarring linked to about 4-fold higher rate of graft failure

HR 4 (95% CI 1.12 to 14.27)
null 1
1.12
14.27
CI excludes the null - significant
More results

Biopsy-proven recurrent IgAN was identified in 40 of 1474 for-cause biopsy recipients (2.7%).

Median time from recurrence to graft failure was 2.46 years.

Graft loss was attributed primarily to recurrent IgAN in 7 patients (70.0%) and associated with rejection in 3 (30.0%).

More results

Rising creatinine, proteinuria, hematuria, Asian race, and C3 bright deposition showed non-significant trends toward worse graft survival.

“
Conclusion · 1 of 2

In this for-cause biopsy cohort, clinically detected recurrent IgAN was associated with meaningful graft loss.

Conclusion · 2 of 2

Severe chronic injury at recurrence identified patients with poorer prognosis, although this likely reflects advanced nonspecific allograft damage rather than a recurrence-specific mechanism.

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