De novo glomerular diseases after renal transplantation: How is it different from recurrent glomerular diseases?

Table 3 Main characteristics of the more frequent de novo glomerulonephritis after transplantation (minimal change disease, nephrotic syndrome, membranous nephropathy, membranoproliferative glomerulonephritis, hepatitis C virus, IgAN)

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.