Membranous nephropathy in renal allograft recipients: A report of 11 cases

Membranous glomerulopathy is the most common form of de novo glomerulonephritis in renal transplant recipients. Eleven patients with allograft membranous nephropathy were identified at our institution during a 78-month period. Various parameters used to categorize these patients included recipient age, gender, immunosuppression regimen, clinical course, etiology of end-stage renal disease, donor status, and onset of proteinuria relative to time of transplant. All patients with membranous glomerulopathy in our series presented with nephrotic-range proteinuria and subsequently underwent percutaneous allograft biopsy. Features of chronic rejection were found in 10 of 11 patients, ranging from mild to moderate, in addition to the membranous changes. There was no correlation between the severity of rejection and the extent of membranous involvement histologically. Due to its frequency and associated complications, the pathogenesis of allograft membranous nephropathy warrants further study.