Proteinuria/Creatininuria Index and its Correlation With the 24-Hour Proteinuria in Renal Transplanted Patients

Mombelli, C.; Giordani, M.; Imperiali, Nora; Bedini, M.; Luxardo, Rosario; Heredia, Alicia Castañeda; Lovisolo, Patricia; Groppa, Silvia R; Arenaza, Diego Pérez de; Diez, Guillermo Rosa

doi:10.1016/j.transproceed.2013.01.077

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Currently, there is no consensus regarding the optimal method to assess the degree of proteinuria in KTRs [7]. Several studies have reported a high overall correlation between 24-hour urine protein or albumin excretion and spot urine PCR or ACR in KTRs (median correlation coefficient, 0.92; range, 0.772-0.998) [24][25][26][27][28], although one study showed only modest accuracy of spot urine PCR or ACR for prediction of 24-hour urine protein excretion despite high correlation between spot urine PCR or ACR and 24hour urine protein excretion [29]. However, the correlation between 24-hour urine protein or albumin excretion and spot urine PCR or ACR within 1 month after surgery has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of postoperative proteinuria for prediction of early renal outcomes after kidney transplantation

Jeon

Park

Lee

et al. 2022

Kidney Res Clin Pract

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Background: Proteinuria is associated with poor allograft and patient survival in kidney transplant recipients. However, the clinical relevance of spot urine protein-to-creatinine ratio (PCR) or albumin-to-creatinine ratio (ACR) as predictors of renal outcomes during the early postoperative period following kidney transplantation (KT) has not been determined. Methods: This single-center retrospective cohort study included 353 kidney transplant recipients who underwent KT between 2014 and 2017 and were followed up for more than 3 years. Among them, 186 and 167 recipients underwent living donor KT and deceased donor KT, respectively. The PCR and ACR were measured during the immediate postoperative period (within 7 days postoperatively), before discharge (2-3 weeks postoperatively), and 3-6 months postoperatively. Results: The median age of the patients was 51 years (interquartile range, 43-59 years), and 62.9% were male. An immediate postoperative PCR of ≥1 mg/mg was associated with old age, diabetes mellitus, high systolic blood pressure, delayed graft function, and donor factors (deceased donor KT, old age, and high serum creatinine concentrations). The PCR and ACR 3 to 6 months posttransplant were inversely associated with the estimated glomerular filtration rate at 1 year posttransplant. Deceased donor KT recipients with immediate postoperative PCR of ≥3 mg/mg showed a greater incidence of delayed graft function and lower estimated glomerular filtration rate before discharge than those with immediate postoperative PCR of <3 mg/mg. Conclusion: Early postoperative proteinuria is a useful biomarker to predict early renal outcomes after KT.

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Section: Discussionmentioning

confidence: 99%

Clinical relevance of postoperative proteinuria for prediction of early renal outcomes after kidney transplantation

Jeon

Park

Lee

et al. 2022

Kidney Res Clin Pract

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“…Proteinuria is an early marker of inflammation and renal disease and predictor of allograft dysfunction after kidney transplant [1].Timed urine collection is considered the gold standard to measure proteinuria and albuminuria [2]. However, random Urine Protein Creatinine Ratio (PCR) is commonly used to estimate proteinuria and has increasingly replaced 24 hour urine protein measurement (24-UP) in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Post Renal Transplant Follow Up in Focal Segmental Glomerulosclerosis with 24 Hour Urine Protein Collection - Traditional and True

Mena-Gutierrez¹

2016

Int J Nephrol Kidney Failure

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Urinary protein excretion is crucial to both diagnosis and treatment of many renal disorders as also critical for follow up of kidney allograft function after transplant. Random Urine Protein Creatinine Ratio (PCR) is commonly used to estimate proteinuria. However, there are concerns over diagnostic accuracy of PCR or its correlation with the extent of proteinuria noted on 24 hour urine collection (24-UP). We present a case of a 38 years old Caucasian man with history of end stage renal disease due to primary focal segmental glomerulosclerosis (FSGS). He underwent a deceased donor kidney transplant with immunosuppressive induction and maintenance per hospital protocol. His creatinine and proteinuria as measured by PCR improved progressively. With discharge planning underway, we tested a 24-UP. Unexpectedly, his 24 hour proteinuria was markedly higher than that suggested by the PCR calculated on a spot urine sample. A diagnosis of early recurrence of FSGS was made and the patient was successfully treated with plasmapheresis. In addition, his tacrolimus was changed to cyclosporine. We conclude that it is prudent to routinely monitor proteinuria by timed urine collection in the immediate post-transplant setting for recipients with primary FSGS to avoid delays on appropriate therapy that could impact graft function and survival.

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Evaluation and Management of Proteinuria After Kidney Transplantation

Tsampalieros

Knoll

2015

Transplantation

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Proteinuria occurs commonly after kidney transplantation. Because there are no specific guidelines for defining and detecting proteinuria in transplant recipients, its prevalence can vary depending on the methods used. Most often, the same cutoffs for defining proteinuria in the nontransplant population are applied. There are several risk factors for proteinuria, including some transplant-specific diagnoses and immunosuppressive medications. Posttransplantation proteinuria is associated with reduced graft survival as well as an increased risk of cardiovascular events and death. Treatments to decrease proteinuria have been based on blocking the renin-angiotensin-aldosterone system with the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. This review describes the measurement, prevalence, etiology, prognostic significance, and management of proteinuria in both adult and pediatric transplant recipients.

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Proteinuria/Creatininuria Index and its Correlation With the 24-Hour Proteinuria in Renal Transplanted Patients

Cited by 3 publications

References 14 publications

Clinical relevance of postoperative proteinuria for prediction of early renal outcomes after kidney transplantation

Clinical relevance of postoperative proteinuria for prediction of early renal outcomes after kidney transplantation

Post Renal Transplant Follow Up in Focal Segmental Glomerulosclerosis with 24 Hour Urine Protein Collection - Traditional and True

Evaluation and Management of Proteinuria After Kidney Transplantation

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