Clinicopathologic Features and Risk Factors of Proteinuria in Transplant Glomerulopathy: A Cross-Sectional Study

Q. Zhang¹, K. Budde¹, D. Schmidt¹, F. Halleck¹, M. Dürr¹, M. Naik¹, M. Mayrdorfer¹, W. Düttmann-Rehnolt¹, F. Klauschen², B. Rudolph², K. Wu²

¹Department of Nephrology, Charité – Universitätsmedizin Berlin, Berlin, Germany, ²Department of Pathology, Charité – Universitätsmedizin Berlin, Berlin, Germany

Meeting: 2020 American Transplant Congress

Abstract number: C-089

Keywords: Kidney, Kidney transplantation, Proteinuria, Risk factors

Session Information

Session Name: Poster Session C: Kidney Complications: Immune Mediated Late Graft Failure

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Proteinuria is common after transplantation. Transplant Glomerulopathy (TG), one of the main causes of post-transplant proteinuria, is also a major contributor to graft loss. The features and possible risk factors for proteinuria in TG patients are uncertain.

*Methods: We investigated all patients who received kidney transplantation (Tx) from Jan. 2000 to Dec. 2018 in our center. During this time a total of 2375 indication biopsies due to allograft dysfunction and/or increasing of proteinuria were performed, of which the TG-lesions were found in 346 biopsies of 251 recipients. After exclusion of cases with thrombotic microangiopathy (TMA, n=31), hepatitis C associated membranoproliferative glomerulonephritis (MPGN, n=2) and recurrent/de novo glomerulonephritis (n=32), a total of 186 patients with biopsy-proven TG were enrolled in our retrospectively study. Only the first biopsy for each patient with TG was used for analysis. All the allograft biopsies were diagnosed according to Banff 2017 consensus. The clinical and histological data were compared between two groups with regard to proteinuria (cut-off of 0.5 g/day) at the time of biopsy. The possible risk factors for proteinuria in TG patients were determined by multivariate logistic regression analysis.

*Results: Ninety-seven (52.15%) TG patients had proteinuria > 0.5 g/day at time of biopsy. Patients with proteinuria had higher age (51.52±15.91 vs 47.07±15.41,P=0.015), higher systolic blood pressure(144.43±20.04mmHg vs 134.91±19.81mmHg, P=0.001), diastolic blood pressure(87.73±14.15mmHg vs 78.36±11.23mmHg, P=0.000), cg score (2.41±0.76 vs 2.10±0.78, P=0.007), and mm score (0.85±0.10 vs 0.56±0.09, P=0.037). In multivariate logistic regression models, cg score (OR 2.11; 95% CI 1.29-3.45, P=0.003), diastolic blood pressure (OR 1.06; 95% CI 1.03-1.10, P=0.000), ACEI (OR 0.47; 95% CI 0.22-0.90, 0.023) and MMF (OR 0.46; 95% CI 0.22-0.97, P=0.040) were independent risk or protective factors for proteinuria.

*Conclusions: Proteinuria is common in TG patients. cg score and diastolic blood pressure are risk factors while administration of ACEI and MMF are protective for proteinuria.

To cite this abstract in AMA style:

Zhang Q, Budde K, Schmidt D, Halleck F, Dürr M, Naik M, Mayrdorfer M, Düttmann-Rehnolt W, Klauschen F, Rudolph B, Wu K. Clinicopathologic Features and Risk Factors of Proteinuria in Transplant Glomerulopathy: A Cross-Sectional Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/clinicopathologic-features-and-risk-factors-of-proteinuria-in-transplant-glomerulopathy-a-cross-sectional-study/. Accessed May 16, 2025.

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