https://doi.org/10.4081/aiua.2024.12627
Redefining kidney transplantation procedure among adult lupus nephritis: Expedient review approach and meta-analysis from the last couple of decades
Submitted: April 30, 2024
Accepted: June 6, 2024
Published: October 2, 2024
Accepted: June 6, 2024
Abstract Views: 1263
PDF: 295
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Background: The actual prognostic impact of prior lupus nephritis (LN) diagnosis on end-stage kidney disease (ESKD) patients remains questionable, especially in relation to outcomes of kidney transplantation (KTx) We aim to determine the survival of the graft and recipient after the KTx procedure among patients with ESKD due to LN in comparison to non-LN.
Methods: This meta-analysis included retrospective studies from the last two decades, focusing on the KTx’s outcomes among ESKD due to LN in comparison to non-LN. We establish the graft/recipient survival rate at different follow-up intervals as the primary outcome, and acute graft rejection and pooled graft failure rate as secondary outcomes. All analyses were performed with the random-effect model (REM) and were presented as odd ratio (OR; within 95% confidence interval (CI)). The protocol of this study was registered in PROSPERO: CRD42023394310.
Results: A total of 1,299 KTx (368 LN patients) from 10 studies with >10 years of follow-up were thoroughly reviewed. All checkpoints (at 1-, 5-, 10, and 15-year post-KTx) on graft survival rate demonstrated comparable outcomes in either LN or non-LN (e.g., at 10-year follow up (OR, 1.08 [0.40, 2.91]; p = 0.88). Similar findings at all checkpoints for recipient survival rate were also observed without statistically significant difference between LN and non-LN arm (e.g., at 10-year checkpoint; OR, 0.99 [0.68, 1.46]; p = 0.98). Both of our secondary analyses also presented insignificant differences (p = 0.70 and = 0.16, respectively).
Conclusions: Our findings suggested that prognosis of ESKD due to complicated LN is equal compared to ESKD associated with non-LN etiologies, suggesting the impact of LN as the inducing cause of ESKD on KTx outcome is relatively neglectable.
Wang JH, Skeans MA, Israni AK. Current status of kidney transplant outcomes: dying to survive. Adv Chronic Kidney Dis 2016; 23:28.
DOI: https://doi.org/10.1053/j.ackd.2016.07.001
Chapman JR. What are the key challenges we face in kidney transplantation today? Transplant Res. 2013;2:1-7.
DOI: https://doi.org/10.1186/2047-1440-2-S1-S1
Yung S, Yap DYH, Chan TM. A review of advances in the understanding of lupus nephritis pathogenesis as a basis for emerging therapies. F1000Res. 2020;9:F1000 Faculty Rev-905.
DOI: https://doi.org/10.12688/f1000research.22438.1
Hahn BH, McMahon M, Wilkinson A, et al. American College of Rheumatology guidelines for screening, case definition, treatment and management of lupus nephritis. Arthritis Care Res. 2012;64:797-808.
DOI: https://doi.org/10.1002/acr.21664
Barber MRW, Drenkard C, Falasinnu T, et al. Global epidemiology of systemic lupus erythematosus. Nat Rev Rheumatol. 2021; 17:515-32.
DOI: https://doi.org/10.1038/s41584-021-00668-1
Almaani S, Meara A, Rovin BH. Update on lupus nephritis. ClinJ Am Soc Nephrol 2017;12:825-35.
DOI: https://doi.org/10.2215/CJN.05780616
Tektonidou MG, Dasgupta A, Ward MM. Risk of end-stage renal disease in patients with lupus nephritis, 1971-2015: A systematic review and Bayesian meta-analysis. Arthritis Rheumatol 2016;68:1432-41.
DOI: https://doi.org/10.1002/art.39594
Newman KL, Fedewa SA, Jacobson MH, et al. Racial/ethnic differences in the association between hospitalization and kidney transplantation among waitlisted end stage renal disease patients. Transplantation. 2016;100:2735-45.
DOI: https://doi.org/10.1097/TP.0000000000001072
Rybicka-Kozlowska E, Andreoni K, Kozlowski T. Racial differences in renal transplantation: How do we bridge the gap? Surgury. 2021;170:333-5.
DOI: https://doi.org/10.1016/j.surg.2021.02.030
Joanna Briggs Institute [Internet]. Checklist for Cohort Studies. 2020. Available from: https://jbi.global/sites/default/files/2021-10/Checklist_for_Cohort_Studies.docx
Joanna Briggs Institute [Internet]. Checklist for Case Control Studies. 2020. Available from: https://jbi.global/sites/default/files/2021-10/Checklist_for_Case_Control_Studies.docx
Ranganathan P, Aggarwal R, Pramesh C. Common pitfalls in statistical analysis: Odds versus risk. Perspect Clin Res. 2015;6:222.
DOI: https://doi.org/10.4103/2229-3485.167092
Lanza A, Ravaud P, Riveros C, Dechartres A. Comparison of estimates between cohort and case-control studies in meta-analyses of therapeutic interventions: A meta-epidemiological study. PLoS One. 2016;11:1-12.
DOI: https://doi.org/10.1371/journal.pone.0154877
Ghafari A, Etemadi J, Ardalan MR. Renal transplantation in patients with lupus nephritis: a single-center experience. Transplant Proc. 2008;40:143-4.
DOI: https://doi.org/10.1016/j.transproceed.2007.12.013
Horta-Baas G, Camargo-Coronel A, Miranda-Hernández DG, et al. Renal transplantation in systemic lupus erythematosus: Comparison of graft survival with other causes of end-stage renal disease. Reumatol Clin. 2019;15:140-5.
DOI: https://doi.org/10.1016/j.reumae.2018.10.012
Lionaki S, Kapitsinou PP, Iniotaki A, et al. Kidney transplantation in lupus patients: A case-control study from a single centre. Lupus. 2008;17:670-5.
DOI: https://doi.org/10.1177/0961203308089430
Moroni G, Tantardini F, Gallelli B, et al. The long-term prognosis of renal transplantation in patients with lupus nephritis. Am J Kidney Dis. 2005;45:903-11.
DOI: https://doi.org/10.1053/j.ajkd.2005.01.038
Naranjo-Escobar J, Manzi E, Posada JG, et al. Kidney transplantation for end-stage renal disease in lupus nephritis, a very safe procedure: A single Latin American transplant center experience. Lupus. 2017;26:1157-65.
DOI: https://doi.org/10.1177/0961203317696591
Pampa-Saico S, Marcén-Letosa R, Fernández-Rodríguez A, et al. Kidney transplantation in systemic lupus erythematosus: Outcomes and prognosis. Med Clin 2019;153:460-3.
DOI: https://doi.org/10.1016/j.medcle.2019.10.002
Park H, Park WY, Kang SS, et al. clinical outcomes of kidney transplantation in patients with biopsy-proven glomerulonephritis. Transplant Proc. 2018;50:1009-12.
DOI: https://doi.org/10.1016/j.transproceed.2018.02.039
Ramirez-Sandoval JC, Chavez-Chavez H, Wagner M, et al. Long-term survival of kidney grafts in lupus nephritis: a Mexican cohort. Lupus. 2018;27:1303-11.
DOI: https://doi.org/10.1177/0961203318770527
Roozbeh J, Eshraghian A, Raeesjalali G, et al. Outcomes of kidney transplantation in patients with systemic lupus erythematosus. Iran J Kidney Dis. 2011; 5:53-6.
Yu TM, Chen YH, Lan JL, et al. Renal outcome and evolution of disease activity in Chinese lupus patients after renal transplantation. Lupus. 2008; 17:687-94.
DOI: https://doi.org/10.1177/0961203308089439
Kupiec-Weglinski JW. Grand challenges in organ transplantation. Front Transplant. 2022;1:1-5.
DOI: https://doi.org/10.3389/frtra.2022.897679
Black CK, Termanini KM, Aguirre O, et al. Solid organ transplantation in the 21st century. Ann Transl Med. 2018;6:409-409.
DOI: https://doi.org/10.21037/atm.2018.09.68
Kaballo MA, Canney M, O’Kelly P, et al. A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clin Kidney J. 2018;11:389-93.
DOI: https://doi.org/10.1093/ckj/sfx117
Yngman-Uhlin P, Fogelberg A, Uhlin F. Life in standby: Hemodialysis patients’ experiences of waiting for kidney transplantation. J Clin Nurs. 2016;25:92-8.
DOI: https://doi.org/10.1111/jocn.12994
Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017; 32:243-8.
DOI: https://doi.org/10.1007/s00467-016-3383-8
NHS Blood and Transplant. Kidney acceptance criteria. Available from: https://www.odt.nhs.uk/transplantation/kidney/kidney-acceptance-criteria/#
Pramudya D, Hertanto DM, Pitaloka AT, Tjempakasari A, Pranawa. Lupus nephritis and kidney transplantation: past, present and future. Bali Med J. 2023;12:1802-7.
Pattanaik D, Green J, Talwar M, Molnar M. Relapse and outcome of lupus nephritis after renal transplantation in the modern immunosuppressive era. Cureus. 2022; 14:e20863.
DOI: https://doi.org/10.7759/cureus.20863
Chadban SJ, Ahn C, Axelrod DA, et al. KDIGO clinical practice guideline on the evaluation and management of candidates for kidney transplantation. Transplantation. 2020;104:S11-S103.
DOI: https://doi.org/10.1097/TP.0000000000003136
Fanouriakis A, Kostopoulou M, Cheema K, et al. 2019 Update of the Joint European League against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020; 79:S713-23.
DOI: https://doi.org/10.1136/annrheumdis-2020-eular.3936
Wilhelmus S, Bajema IM, Bertsias GK, et al. Lupus nephritis management guidelines compared. Nephrol Dial Transplant. 2016;31:904-13.
DOI: https://doi.org/10.1093/ndt/gfv102
Morales E, Galindo M, Trujillo H, Praga M. Update on lupus nephritis: looking for a new vision. Nephron. 2021; 145:1-13.
DOI: https://doi.org/10.1159/000511268
Rodelo J, González LA, Ustáriz J, et al. Kidney transplantation outcomes in lupus nephritis: A 37-year single-center experience from Latin America. Lupus. 2021; 30:1644-59.
DOI: https://doi.org/10.1177/09612033211028663
Legendre C, Canaud G, Martinez F. Factors influencing long-term outcome after kidney transplantation. Transpl Int. 2014; 27:19-27.
DOI: https://doi.org/10.1111/tri.12217
Albuquerque BC, Salles VB, Tajra RDP, Rodrigues CEM. Outcome and prognosis of patients with lupus nephritis submitted to renal transplantation. Sci Rep. 2019;9:11611.
DOI: https://doi.org/10.1038/s41598-019-48070-y
Gergianaki I, Bortoluzzi A, Bertsias G. Update on the epidemiology, risk factors, and disease outcomes of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 2018;32:188-205.
DOI: https://doi.org/10.1016/j.berh.2018.09.004
Nee R, Jindal RM, Little D, et al. Racial differences and income disparities are associated with poor outcomes in kidney transplant recipients with lupus nephritis. Transplantation. 2013; 95:1471-8.
DOI: https://doi.org/10.1097/TP.0b013e318292520e
Palumbo SA, Robishaw JD, Krasnoff J, Hennekens CH. Different biases in meta-analyses of case-control and cohort studies: an example from genomics and precision medicine. Ann Epidemiol. 2021; 58:38-41.
DOI: https://doi.org/10.1016/j.annepidem.2021.02.013
How to Cite
Warli, S. M., Ginting, A. R., Firsty, N. N., Velaro, A. J., Sembiring, S. C., Darlan, D. M., & Tala, Z. Z. (2024). Redefining kidney transplantation procedure among adult lupus nephritis: Expedient review approach and meta-analysis from the last couple of decades. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12627
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.