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 language | English (US) |
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Pages (from-to) | 1660-1665 |
Number of pages | 6 |
Journal | American Journal of Transplantation |
Volume | 6 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2006 |
Keywords
- Glomerulonephritis
- Kidney transplantation
- Proteinuria
- Recurrence
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)