The aim of the study was to analyze the possible detrimental effect of renal dysfunction (serum creatinine SCr) and proteinuria (>300 mg/day) on graft loss after renal transplantation in the short-term.
From the Spanish Chronic Allograft Nephropathy database (renal transplants in 1990, 1994, 1998 and 2002) 4842 patients were available, 3950 of them alive and with graft function at one year were included in the study. We divide this population in three groups according to renal function and proteinuria at one year: SCr >1.5 mg/d and negative proteinuria (Group I, 36.1%), SCr>1.5 mg/d and positive proteinuria (Group II, 20.9%)) and SCr <1.5 mg/dl and negative proteinuria (Group III, 36.1%).
In the global population, patients of Group II showed a significantly lower death-censored- graft (DCGS) and patient survival at 4 years (81.7% and 94% respectively) (p < 0.001) compared to group I (95.5% and 96%) and to group III (98% and 98%). As expected, in group II, the main cause of graft loss was chronic rejection (80%) and cardiovascular disease and infection were the main causes of death.
In the subpopulation of older recipients who received kidneys from older donors, n:294, at one year, 42.5 % of patients were included in group I, 34% in group II and only 23.5% in group III, showing a significantly lower DCGS (but not in patient survival) those included in group II.(90% vs 95.8 and 98.4% respectively) (p<0.05). Although with different percentages in transplantation from young donors for young recipients n: 2908: 34.5%, 18.1% and 47.4 % respectively, a significant lower DCGS was also observed at 4 years in group II (79.7% vs 95% and 98.4%(p<0.001) and in patient survival (96 % vs 97% and 98.4% (p<0.05).
In summary, the combination of renal dysfunction plus proteinuria at one year posttransplantation has a harmful effect on survival figures. These data strongly suggest that this parameter is an excellent predictor of graft loss in the short-term including transplantation in young and older recipients. To improve graft survival an early intervention in both clinical findings are mandatory.
To cite this abstract in AMA style:Munoz-Robles J, Samaniego L, Marcén R, Andrés A, Serón D, Morales J. Combination of Renal Dysfunction Plus Proteinuria at One Year Is a Strong Predictor of Early Graft Loss after Renal Transplantation. A National Spanish Study, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/combination-of-renal-dysfunction-plus-proteinuria-at-one-year-is-a-strong-predictor-of-early-graft-loss-after-renal-transplantation-a-national-spanish-study-the/. Accessed December 6, 2019.
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