IS KIDNEY GRAFT BIOPSY INDICATED IN RECIPIENTS WITH NEWLY DEVELOPED, MICROSCOPIC HEMATURIA

We actively performed renal allograft biopsies on 87 living donor rena l transplant recipients presenting with stable serum creatinine but sh owing newly developed recurrent microscopic hematuria with a small amo unt of proteinuria during the maintenance phase of immunosuppression a nd found definite pathological lesions in 56 cases (64%). Chronic reje ction of a mild grade (n = 27) and various kinds of glomerulonephritis (n = 27) were the major pathological diagnoses, and from 14 cases sin gular or complicated cyclosporine (CsA) toxicity was found. Twenty-fou r out of the 27 glomerulonephritis cases were IgA nephropathy, which i s the most common glomerulonephritis in Korea. Through this study, the authors found chronic rejection or glomerulonephritis even in grafts which are generally considered to be normal. CsA nephrotoxicity, which was not expected clinically, could be found. In summary, renal allogr aft biopsy on patients, even with stable graft function when they star t to show microscopic hematuria with or without a small amount of prot einuria, should be perfomed to document the early intragraft events if there are no medical contraindications.