Proteinuria in pediatric renal transplant recipients

Abstract

Proteinuria has been shown to be an important and potentially treatable risk factor for graft loss. The aim of this study was to evaluate prevalence, etiology, and outcome of proteinuria during the follow-up of children with renal transplantation. We retrospectively reviewed the files of renal transplanted children between 2006 and 2016 in our center. All patients were interpreted with respect to the demographic data and clinical and laboratory features including information about proteinuria. Chi-square test and Mann-Whitney U test were used for analysis. Fifty-two children were eligible for the study. Proteinuria was observed in 34 (65%) and nephrotic range proteinuria was detected in 5 (9.6%) patients. Etiology of proteinuria could be identified in 21 patients. Acute rejection and uncontrolled hypertension were the most frequent causes of proteinuria. Proteinuria had resolved during the follow-up in 59% of the patients. We found that children with and without proteinuria had similar glomerular filtration rate at the end of 50 months of follow-up period. Proteinuria seems to be a common complication in renal transplant recipients. Graft functions can be preserved by immediate evaluation of increasing proteinuria, and by fixing treatable causes rapidly and efficiently during the follow-up in majority of the patients.

A Lesson of Immunosuppression in Renal Transplant: Retreat or Hold?

“…Further, when it comes to renal transplantation, the urine has provided valuable information, as it is directly attached to the graft, together with its advantage of being non-invasive and less expensive. Indicating structural damage to the glomerular filtration barrier, to the best of our knowledge, proteinuria is assumed to be a powerful risk factor of progressive renal damage and subsequent renal function abnormality in kidney transplant recipients for years [19,20]. Evidence from a paper published a few decades ago, indicated that albuminuria prognostic strength surpasses that of renal function [21].…”

“…Evidence from a paper published a few decades ago, indicated that albuminuria prognostic strength surpasses that of renal function [21]. However, in regard to determine the immune status in recipients, the validity of proteinuria measurements in the kidney transplant recipients remains less conclusive [19]. Cases of COT in kidney transplantation are not that common, and in a study involving a recent Europe-wide survey of a total of 147 centers, there was a cumulative 0.03% incidence of COT in the cumulative experience of 218,913 kidney transplantations [22].…”

Improving the urine spot protein/creatinine ratio by the estimated creatinine excretion to predict proteinuria in pediatric kidney transplant recipients

“…The assessment of proteinuria may have an essential value in evaluating the effectiveness of treatment and disease recurrence or progression 1 . Albuminuria and proteinuria, common in kidney transplant recipients, have been associated with deteriorating kidney functions, increased risk for cardiovascular disease, graft loss, and mortality 2,3 …”