Introduction. Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients

Aim. To assess whether the combination of early low-grade proteinuria (<1 g/day) and allograft dysfunction at the third month post-transplantation predicts outcomes in terms of survival in ECD kidney transplant recipients.

Material and Methods. We studied a cohort of 269 ECD kidney transplant recipients subdivided into four groups according to clinically relevant proteinuria (300 mg/day) and median creatinine (1.7 mg/dL, IR, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr <1.7 mg/dL and proteinuria <300 mg/24 h, n=97), Group B (Cr <1.7 mg/dL and proteinuria ≥300 mg/24 h, n=38), Group C (Cr ≥1.7 mg/dL and proteinuria <300 mg/24 h, n=79) and Group D (Cr ≥1.7 mg/dL and proteinuria ≥300 mg/24 h, n=55).

Results.Death-censored graft survival was significantly lower in Group D compared with the rest (P<0.007). Multivariate Cox regression analysis using fixed covariates showed that the combination of low-grade proteinuria and a lower eGFRas associated with graft failure (HR 2.5, 95%CI, 1.09–5.97; P=0.03).

Conclusions. The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population.

CITATION INFORMATION: López V, Cabello M, Ruiz P, Jironda C, Burgos D, González-Molina M, Hernández D. Impact of Allograft Dysfunction and Early Low Grade Proteinuria on Survival in Expanded Criteria Donor Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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