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Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age.
Diena, Davide; Messina, Maria; De Biase, Consuelo; Fop, Fabrizio; Scardino, Edoardo; Rossetti, Maura M; Barreca, Antonella; Verri, Aldo; Biancone, Luigi.
Afiliação
  • Diena D; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • Messina M; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • De Biase C; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • Fop F; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • Scardino E; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • Rossetti MM; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy.
  • Barreca A; Division of Pathology, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Turin, Italy.
  • Verri A; Department of Vascular Surgery, "Città della Salute e della Scienza Hospital", University of Turin, Turin, Italy.
  • Biancone L; Renal Transplant Center "A. Vercellone", Nephrology, Dialysis and Renal Transplant Division, "Città della Salute e della Scienza Hospital", Department of Medical Sciences, University of Turin, Corso Dogliotti14, 10126, Torino, Italy. luigi.biancone@unito.it.
BMC Nephrol ; 20(1): 443, 2019 12 02.
Article em En | MEDLINE | ID: mdl-31791270
ABSTRACT

BACKGROUND:

Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored.

METHODS:

This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day.

RESULTS:

Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥ 44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (Hazard Ratio 2.77 vs Hazard Ratio 2.46). Low-grade proteinuria (0.2-0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥0.5 effect was more significant with donors > 50 years old (Odd Ratio 2.3).

CONCLUSIONS:

Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Proteinúria / Doadores de Tecidos / Fatores Etários / Efeitos Adversos de Longa Duração / Falência Renal Crônica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Proteinúria / Doadores de Tecidos / Fatores Etários / Efeitos Adversos de Longa Duração / Falência Renal Crônica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Itália