*Purpose: Recurrent and de novo glomerular diseases documented to develop in 10-15% of kidney transplant recipients and are the third leading cause of allograft loss. We aimed to study those impacts in our cohort, mainly dominated by Hispanics and African Americans.

*Methods: We retrospectively studied the entire adult isolated kidney transplant recipients at our center from April 2009 till June 2017 to evaluate the prevalence and impact of recurrent and de novo glomerular diseases after transplantation. Transplant kidney biopsies are performed as clinically indicated at any time point after transplantation for rising creatinine (more than 25% increase in creatinine from baseline) and/or proteinuria (more than 500 mg/day).

*Results: From April 2009 to June 2017, a total of 1062 adult renal transplants were performed. The etiology of kidney disease was as the following: 36% diabetes mellitus, 29% hypertension, 13.1 % glomerular disease (focal segmental glomerulosclerosis (FSGS), IgA, membranous, membranoproliferative, and systemic lupus), 4.2 % polycyctic kidney disease and 17.7% others. During a median follow up of 3.8 (1.2-6.2) years after transplantation, a total of 32 (3%) cases of biopsy proven recurrent and de novo glomerular disease were diagnosed. The most common form of glomerular disease was FSGS seen in 21 patients (11 recurrent, 5 de novo and 5 unclear); followed by recurrent membranoproliferative glomerulonephritis in 2; recurrent diabetic nephropathy in 2, recurrent immunoglobulin A nephritis in 1, recurrent immune complex GN in 1, recurrent lupus nephritis in 1 and recurrent membranous nephritis in 1 patient.These patients were compared with other patients who did not have recurrent and de novo glomerular disease (n=1030). There were less male (50.0 % vs. 61.2%, P<0.035) and less number of re-transplants (0.1 % vs. 3.125 %, P<0.005) in the recurrent and de novo disease group. There was no difference in terms of race (African Americans vs. Hispanics vs. White, P=NS). Other demographic findings were not significantly different. The diagnosis of recurrent and de novo glomerular disease was made at a median period of 442 days (17-2105) after the transplant . During the follow-up period, there were significantly more graft failures in the recurrent or de novo glomerular disease group (43.75% vs. 8.4%, P<0.001) and less patient survival rate (81.25 % vs. 92.93%, P<0.001).

*Conclusions: Although, recurrent and de novo disease is not common in our patient population, it is associated with significantly poorer long-term patient and graft survival independently of the recipient race.

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