INTRODUCTION: Proteinuria in renal transplant recipients has been recognized as a risk factor of progression of chronic allograft nephropathy and for cardiovascular disease, the main causes of transplant failure. PATIENTS AND METHODS: We analyzed the risk factors for persistent proteinuria (>0.5 g/day) among 337 kidney allograft recipients with a minimum follow-up of 6 months, among a series of 375 transplants performed during a decade, as well as their association with allograft and patient survivals. Patients with proteinuria greater than 0.5 g/d were treated with angiotensin-converting enzyme inhibitors (ACEI) and/or angiotensin-receptor blockers. RESULTS: After a mean follow-up of 53.35 +/- 52.63 months, 68 patients (20.17%) had persistent proteinuria greater than 0.5 g/d. Female patients (P = .012), body mass index (BMI) >25 (P = .008), pretransplant HLA sensitization (P = .039), and delayed graft function (DGF; P = .001) were associated with proteinuria. Induction treatment with antithymocyte globulin (P = .030) and treatment with tacrolimus instead of cyclosporine (P = .046) were associated with an increased risk of proteinuria. Multivariate analysis confirmed the independent value of DGF (RR = 2.23; 95% confidence interval [CI] 1.22 to 4.07; P = .009) and BMI >25 (RR = 1.968; 95% CI 1.05 to 3.68; P = .035) to predict postransplant proteinuria. The mean values of serum creatinine (P = .000) and systolic blood pressure (P < .05) were persistently higher from the early stages after transplantation in the proteinuric group. Graft survival at 5 years was 69% among patients who developed proteinuria and 93% in those without proteinuria (P = .000), with no differences in patient survival (P = .062). CONCLUSION: Proteinuria in renal transplant recipients was related to immunological and nonimmunological factors, some of which, such as hypertension and obesity could be modifiable. Proteinuria in renal transplant recipients predicted a worse allograft survival despite of intensive treatment of hypertension including ACEI/angiotensin-receptor blockers.
INTRODUCTION:Proteinuria in renal transplant recipients has been recognized as a risk factor of progression of chronic allograft nephropathy and for cardiovascular disease, the main causes of transplant failure. PATIENTS AND METHODS: We analyzed the risk factors for persistent proteinuria (>0.5 g/day) among 337 kidney allograft recipients with a minimum follow-up of 6 months, among a series of 375 transplants performed during a decade, as well as their association with allograft and patient survivals. Patients with proteinuria greater than 0.5 g/d were treated with angiotensin-converting enzyme inhibitors (ACEI) and/or angiotensin-receptor blockers. RESULTS: After a mean follow-up of 53.35 +/- 52.63 months, 68 patients (20.17%) had persistent proteinuria greater than 0.5 g/d. Female patients (P = .012), body mass index (BMI) >25 (P = .008), pretransplant HLA sensitization (P = .039), and delayed graft function (DGF; P = .001) were associated with proteinuria. Induction treatment with antithymocyte globulin (P = .030) and treatment with tacrolimus instead of cyclosporine (P = .046) were associated with an increased risk of proteinuria. Multivariate analysis confirmed the independent value of DGF (RR = 2.23; 95% confidence interval [CI] 1.22 to 4.07; P = .009) and BMI >25 (RR = 1.968; 95% CI 1.05 to 3.68; P = .035) to predict postransplant proteinuria. The mean values of serum creatinine (P = .000) and systolic blood pressure (P < .05) were persistently higher from the early stages after transplantation in the proteinuric group. Graft survival at 5 years was 69% among patients who developed proteinuria and 93% in those without proteinuria (P = .000), with no differences in patient survival (P = .062). CONCLUSION:Proteinuria in renal transplant recipients was related to immunological and nonimmunological factors, some of which, such as hypertension and obesity could be modifiable. Proteinuria in renal transplant recipients predicted a worse allograft survival despite of intensive treatment of hypertension including ACEI/angiotensin-receptor blockers.
Authors: Tomáš Rosík; Mária Chadimová; Jiří Dušek; Jaromír Háček; Naděžda Šimánková; Karel Vondrák; Jakub Zieg; Tomáš Seeman Journal: Pediatr Nephrol Date: 2015-04-30 Impact factor: 3.714
Authors: Angela C Nolin; Ryan M Mulhern; Maria V Panchenko; Anna Pisarek-Horowitz; Zhiyong Wang; Orian Shirihai; Steven C Borkan; Andrea Havasi Journal: Am J Physiol Renal Physiol Date: 2016-08-31
Authors: Ubiracé Fernando Elihimas Júnior; Jamila Pinho Couto; Wallace Pereira; Michel Pompeu Barros de Oliveira Sá; Eduardo Eriko Tenório de França; Filipe Carrilho Aguiar; Diogo Buarque Cordeiro Cabral; Saulo Barbosa Vasconcelos Alencar; Saulo José da Costa Feitosa; Thais Oliveira Claizoni Dos Santos; Helen Conceição Dos Santos Elihimas; Emilly Pereira Alves; Marcio José de Carvalho Lima; Frederico Castelo Branco Cavalcanti; Paulo Adriano Schwingel Journal: J Aging Res Date: 2020-08-19
Authors: Jose Maria Morales; Roberto Marcén; Domingo del Castillo; Amado Andres; Miguel Gonzalez-Molina; Federico Oppenheimer; Daniel Serón; Salvador Gil-Vernet; Ildefonso Lampreave; Francisco Javier Gainza; Francisco Valdés; Mercedes Cabello; Fernando Anaya; Fernando Escuin; Manuel Arias; Luis Pallardó; Jesus Bustamante Journal: Nephrol Dial Transplant Date: 2012-12 Impact factor: 5.992
Authors: Jung Nam An; Jung Pyo Lee; Yun Jung Oh; Yun Kyu Oh; Jong-Won Ha; Dong-Wan Chae; Yon Su Kim; Chun Soo Lim Journal: Kidney Res Clin Pract Date: 2012-09-19