ArticlePloS one2026
Incidence and risk factors for recurrent IgA nephropathy after kidney transplantation: A multicenter cohort study from Denmark.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecurrent immunoglobulin A nephropathy after kidney transplantation remains a major clinical challenge, but risk factors are not fully defined. This study aimed to evaluate the incidence of biopsy-proven recurrent IgAN and identify risk factors for recurrence in a contemporary Scandinavian cohort.
methodsWe conducted a multicenter cohort study including adult patients with biopsy-proven immunoglobulin A nephropathy who received a first kidney-only transplantation between 1990 and 2020 across two Danish transplantation centers. Recurrence incidence and associations with clinical and donor-related characteristics were assessed during follow-up.
resultsA total of 118 recipients were followed for a median of 5.5 years. Biopsy-confirmed recurrence occurred in 14% of patients, corresponding to a cumulative incidence of 16% at 10 years post-transplantation. Younger age at immunoglobulin A nephropathy diagnosis, faster progression to kidney failure, and receipt of a kidney from a living or genetically related donor were independently associated with an increased risk of recurrence. Maintenance post-transplant steroid use was not associated with recurrence. Recurrent immunoglobulin A nephropathy was associated with an increased risk of graft failure compared with non-recurrent disease (unadjusted HR 3.8; adjusted HR 6.7).
conclusionsRecurrence of IgAN after kidney transplantation remains a clinically significant challenge, associated with younger age, rapid progression to KF, and transplantation from living or genetically related donors. Maintenance post-transplant steroid use was not associated with recurrence risk in this cohort. Larger and more diverse cohorts are warranted to clarify donor-related risk, strengthen the evidence on immunosuppressive protocols and guide strategies to improve graft outcomes.
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