The Authors Reply

Penelope J. Allen, Steven J. Chadban, Jonathan C. Craig, Wai H. Lim, Richard D.M. Allen, Philip A. Clayton, Armando Teixeira-Pinto, Germaine Wong

Research output: Contribution to journalComment/debate

Abstract

We thank Iolanda Godhino and Agnes Fogo for their comments1 on the paper.2 As a large registry study, the reported recurrence rates are likely to be an underestimate of the true rate. Certainly, our analyses would have benefited from immunofluorescence staining and electron microscopy information, but the Australian and New Zealand Dialysis and Transplant registry do not verify the histological and immunofluorescence findings in those reported to experience recurrent glomerulonephritis (GN). Detailed descriptions of the membranoproliferative GN cohort, as well as individual outcomes for each GN subtype, are worthy of being addressed on an individual basis in future publications.

Shorter total ischemic time was identified as a potential risk factor for recurrent IgA nephropathy, but a similar association was not observed for other GN subtypes. We agree that shorter ischemic time may be regarded as a surrogate marker for kidneys received from live donors, but living donor transplant per se was not a significant risk factor for recurrence of IgA nephropathy. The unexpected observed finding between shorter ischemic time and recurrence of IgA nephropathy may simply have occurred by chance or have been a reflection of greater statistical power among recipients with IgA nephropathy, compared with other GN subtypes, to detect a statistically significant effect. Given this continued uncertainty and the recent developments described by Gharavi et al.,3 international collaboration via the establishment of an international GN registry may pave the way to addressing the gaps in existing data.
Original languageEnglish
Pages (from-to)1291
Number of pages1
JournalKidney International
Volume92
Issue number5
DOIs
Publication statusPublished - 18 Oct 2017
Externally publishedYes

Keywords

  • reply
  • Immunofluorescence
  • glomerulonephritis

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