Interpreting post-transplant proteinuria in patients with proteinuria pre-transplant

M. Myslak, H. Amer, P. Morales, M. E. Fidler, J. M. Gloor, T. S. Larson, M. D. Stegall, F. G. Cosio

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Increasing numbers of patients receive kidney transplants before initiation of dialysis or shortly thereafter. Some of these patients have significant proteinuria pre-transplant making the interpretation of post-transplant proteinuria problematic. In this study, we evaluated post-transplant proteinuria in 115 patients who had urine protein measured within 3 months of transplant and assessed the association of proteinuria with allograft pathology. Proteinuria declined rapidly from 3650 ± 3702 mg/day pre-transplant to 550 + 918 at 3 weeks (p < 0.0001) and continued to decline until 1 year post-transplant (472 ± 1116, p < 0.0001 vs. 3 weeks). Proteinuria greater than 3000 mg/day was present in 48 patients (42%) pre-transplant, in 1 patient (1%) at 3 weeks and in 4 patients (4%) at 1 year. Surveillance graft biopsies were done at 1 year in 93% of patients. Proteinuria ≥1500 mg/day and/or an absolute increase in proteinuria >500 mg/day after 3 weeks post-transplant was associated with allograft glomerular pathology. In conclusion, pre-transplant proteinuria, even when high grade, declines rapidly after transplantation. Failure to decline or persistence of proteinuria greater than 1500 mg/day is indicative of allograft pathology.

Original languageEnglish (US)
Pages (from-to)1660-1665
Number of pages6
JournalAmerican Journal of Transplantation
Volume6
Issue number7
DOIs
StatePublished - Jul 2006

Keywords

  • Glomerulonephritis
  • Kidney transplantation
  • Proteinuria
  • Recurrence

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Myslak, M., Amer, H., Morales, P., Fidler, M. E., Gloor, J. M., Larson, T. S., Stegall, M. D., & Cosio, F. G. (2006). Interpreting post-transplant proteinuria in patients with proteinuria pre-transplant. American Journal of Transplantation, 6(7), 1660-1665. https://doi.org/10.1111/j.1600-6143.2006.01361.x