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Journal of Nephrology
Published in: Journal of Nephrology 1/2019

01-02-2019 | Original Article

Key role of renal biopsy in management of progressive chronic kidney disease in liver graft recipients

Authors: Martin-Walter Welker, Nina Weiler, Wolf Otto Bechstein, Eva Herrmann, Christoph Betz, Mark Schöffauer, Stefan Zeuzem, Christoph Sarrazin, Kerstin Amann, Oliver Jung

Published in: Journal of Nephrology | Issue 1/2019

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Abstract

Aims

Chronic kidney disease (CKD) is a common complication after liver transplantation (LT). The etiology of CKD is broad and may only be assessed accurately by renal histology. The current study aimed to analyze the safety of renal biopsy in daily clinical practice as well as its usefulness regarding management of CKD after LT.

Methods

We performed a retrospective analysis of clinical data and renal biopsies obtained from patients with severe renal impairment (overt proteinuria, progressive deterioration of renal function) after LT with respect to safety, etiology of renal disease, and therapeutic consequences.

Results

Renal biopsies were obtained from 14 patients at median (minimum–maximum) 3 (0.2–12) years after LT. No major complications associated with renal biopsy were observed. Histomorphological alterations were varied (nephrosclerosis, n = 5; IgA-glomerulonephritis, n = 4; tenofovir-associated nephropathy, membranoproliferative glomerulonephritis type 1, membranous glomerulonephritis, amyloid A amyloidosis, and calcineurin inhibitor nephropathy, n = 1, respectively). The diagnosis of specific renal diseases other than calcineurin-inhibitor nephrotoxicity facilitated specific treaments and avoided unnecessary modification of immunosuppression in the majority of patients.

Conclusions

Renal biopsy in patients with CKD after LT seems safe and may offer specific therapeutic options. Furthermore, unnecessary changes of immunosuppression can be avoided in a considerable number of patients.
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Metadata
Title
Key role of renal biopsy in management of progressive chronic kidney disease in liver graft recipients
Authors
Martin-Walter Welker
Nina Weiler
Wolf Otto Bechstein
Eva Herrmann
Christoph Betz
Mark Schöffauer
Stefan Zeuzem
Christoph Sarrazin
Kerstin Amann
Oliver Jung
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Journal of Nephrology / Issue 1/2019
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-018-0506-2

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