Increase in proteinuria >200 mg/g after late rejection is associated with poor graft survival

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Arjang DjamaliBrenda L Muth

Abstract

There is no information on the effects of proteinuria on outcomes following rejection. We addressed this question in a retrospective study of 925 kidney transplant recipients between January 2003 and December 2007. Selection criteria were based on (i) biopsy proven diagnosis of a first episode of acute rejection, and (ii) available data on urine protein to creatinine (UPC) ratios at baseline (lowest serum creatinine before biopsy), time of biopsy and 1 month after biopsy. We examined the effects of a change in UPC (DeltaUPC = UPC 1 month after biopsy-baseline UPC) on outcomes. We identified 82 patients with both acute rejection and available data on proteinuria. Mean time (+/-SE) to acute rejection was 19 +/- 2.3 months, and patients were followed up for 38.7 +/- 2.6 months after transplant. Median DeltaUPC was 200 mg/g (95% confidence interval 0.00 to 0.300). Forty-two patients had a DeltaUPC > or =200 (high proteinuria group). Baseline characteristics were similar between high and low proteinuria groups except for more induction therapy with interleukin-2 receptor blockade in the former (71 vs. 47%, P = 0.04). Patient with DeltaUPC > or =200 had higher rates of graft loss (26 vs. 15%, P = 0.01) or combined graft loss or death...Continue Reading

References

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Citations

Aug 28, 2014·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Tomáš Seeman
Aug 2, 2016·Journal of Transplantation·Viktor DenisovOlga Zakharova
Apr 13, 2017·BioMed Research International·Maria MajernikovaJitse P van Dijk
Mar 31, 2011·American Journal of Nephrology·Maria MajernikovaJitse P van Dijk
Nov 7, 2012·American Journal of Nephrology·Maria MajernikovaJitse P van Dijk
Sep 4, 2015·Transplantation·Anne Tsampalieros, Greg A Knoll

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