The Clinical Significance of Early Proteinuria After Renal Transplantation
The Clinical Significance of Early Proteinuria After Renal Transplantation
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DOI：
10.1097/tp.0b013e3181c352c5
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发表时间：
2010-01-27
期刊：
影响因子：
6.2
通讯作者：
Baker, Richard J.
中科院分区：
文献类型：
--
作者：
Cherukuri, Aravind;Welberry-Smith, Matthew P.;Baker, Richard J.
Background. Late-onset proteinuria after renal transplantation has been universally associated with poor allograft outcomes. However, the significance of early low-grade posttransplant proteinuria remains uncertain.Methods. We analyzed the effect of proteinuria 3 months posttransplantation on death-censored graft loss, death with a functioning graft, vascular events within the graft's life, and estimated glomerular filtration rate at 5 years. Four hundred seventy-seven renal transplants from a single center (1988-2003) with a mean follow-up of 122 months were divided into four groups based on the median protein creatinine ratio (PCR) during the 3rd posttransplant month (PCR1.00 [group 4, n=51]). Cox proportional hazards analysis was performed to study the impact of proteinuria on the various outcomes.Results. Multivariate analysis revealed that even low-level proteinuria at 3 months predicted death-censored graft failure (group I [reference]- hazard ratio (HR] = 1, group 2-HR=7.1, group 3-HR = 10.5, group 4-HR 16.0; P=0.001). The impact on death and the occurrence of vascular events was only significant for group 4 (HR: 2.6; P=0.01 for death and HR: 2.2; P=0.04 for vascular events). Estimated glomerular filtration rate at 5 years was group 1, 48.5 mL/min; group 2,41.2 mL/min; group 3, 31.1 mL/min; and group 4,24.5 mL/min (P
