Abstract | BACKGROUND: METHODS: In this retrospective study, we screened all 91 children receiving renal allografts at a single institution between 1997 and 2007. The inclusion criteria were a functioning graft at 1 year posttransplant, data availability and no recurrence of focal-segmental glomerulosclerosis. The final cohort included 75 patients. Proteinuria was considered to be pathologic if the urinary protein/ creatinine ratio was >30 mg/mmol. Donor and recipient characteristics, data on proteinuria, estimated glomerular filtration rate (eGFR) and rejection episodes were analysed. The most recent of the biopsies performed during the follow-up after 1 year posttransplant were analysed separately in the proteinuric group and the non-proteinuric group. RESULTS:
Proteinuria at 1-year posttransplant was pathologic in 35 % of patients. The 5-year graft survival rate was significantly lower in the proteinuric group than in the non-proteinuric group (77 vs. 100 %; p < 0.001). Proteinuria at 1 year posttransplant was associated with reduced long-term graft survival independent of other risk factors, including decreased eGFR or episodes of acute corticosensitive and corticoresistant rejection. The most frequent histologic finding in the proteinuric group was chronic rejection. There was no significant difference in the 5-year patient survival rate between the proteinuric group and the non-proteinuric group. CONCLUSION: This study emphasizes the importance of proteinuria as a prognostic factor of renal allograft survival in children.
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Authors | Tomáš Rosík, Mária Chadimová, Jiří Dušek, Jaromír Háček, Naděžda Šimánková, Karel Vondrák, Jakub Zieg, Tomáš Seeman |
Journal | Pediatric nephrology (Berlin, Germany)
(Pediatr Nephrol)
Vol. 30
Issue 10
Pg. 1853-60
(Oct 2015)
ISSN: 1432-198X [Electronic] Germany |
PMID | 25925040
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Allografts
- Biopsy
- Child
- Child, Preschool
- Creatinine
(urine)
- Czech Republic
(epidemiology)
- Delayed Graft Function
(complications, epidemiology, urine)
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
- Graft Survival
- Humans
- Incidence
- Kidney
(pathology, physiopathology)
- Kidney Failure, Chronic
(surgery)
- Kidney Transplantation
(adverse effects)
- Male
- Prognosis
- Proteinuria
(epidemiology, etiology, urine)
- Retrospective Studies
- Survival Rate
(trends)
- Time Factors
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