Impact of therapeutic changes on renal graft survival with posttransplant glomerulonephritis

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dc.contributor.author Requiao-Moura, L. R.
dc.contributor.author Mastroianni-Kirsztajn, G.
dc.contributor.author Moscoso-Solorzano, G. T.
dc.contributor.author Franco, M. F.
dc.contributor.author Ozaki, K. S.
dc.contributor.author Pacheco-Silva, A.
dc.contributor.author Camara, N. O. S.
dc.date.accessioned 2016-01-24T12:41:57Z
dc.date.available 2016-01-24T12:41:57Z
dc.date.issued 2007-03-01
dc.identifier http://dx.doi.org/10.1016/j.transproceed.2007.01.037
dc.identifier.citation Transplantation Proceedings. New York: Elsevier B.V., v. 39, n. 2, p. 453-456, 2007.
dc.identifier.issn 0041-1345
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/29569
dc.description.abstract Introduction. Posttransplant glomerulonephritis (GN) is the third cause of graft loss after 1 year of transplant follow-up; few approaches have been efficient in reversing this outcome. the aim of this study was to evaluate whether the modification of the immunosuppressive therapy for treating posttransplant GN had an impact on allograft survival. Patients andMethods. Forty-nine patients who underwent renal transplantation and developed posttransplant GN were divided into two groups: group 1, 22 patients with modified immunosuppressive treatment (72.3%, pulse of methylprednisolone; 13.6%, high-dose oral corticosteroid), and group 2, where it was maintained. Additionally, the impact of the concomitant use of drugs that promote the renin-angiotensin-aldosterone system blockade (RAASB) was analyzed in terms of graft survival.Results. We established the diagnosis of GN at 17.9 months (range, 0.57 to 153.4) after transplantation, when serum creatinine (Cr) was 2.2 mg/dL (range, 0.8 to 12.5) and proteinuria 3.2 g/L (range, 0.2 to 24.2). Graft survivals at 1 and 3 years after diagnosis were 69.2% and 52.9%, respectively. the patients of group 1 showed a lower prevalence of graft loss (27.2% versus 48.1%, P =.40) and better survival at the end of 1 year (73.2% versus 60.4%) and 3 years (62.5% versus 38.0%, P =.26), but the differences were not significant. RAASB showed a positive impact on survival at the end of 3 years in both groups: for group 1, 83.8 % with RAASB, 41.4% without RAASB; and for group 2, 75 % with RAASB and 14.8% without RAASB (P < .001).Conclusion. Although treatment of posttransplant GN with modification of immunosuppression seemed to improve graft survival in the first 3 years after diagnosis, RAASB improved this effect. en
dc.format.extent 453-456
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof Transplantation Proceedings
dc.rights Acesso restrito
dc.title Impact of therapeutic changes on renal graft survival with posttransplant glomerulonephritis en
dc.type Artigo
dc.rights.license http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Universidade de São Paulo (USP)
dc.description.affiliation Universidade Federal de São Paulo, Clin & Expt Immunol Lab, BR-04023900 São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Glomerulopathies Sect, Div Nephrol, BR-04023900 São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, Brazil
dc.description.affiliation Univ São Paulo, Dept Immunol, Lab Transplantat Immunobiol, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Clin & Expt Immunol Lab, BR-04023900 São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Glomerulopathies Sect, Div Nephrol, BR-04023900 São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, Brazil
dc.identifier.doi 10.1016/j.transproceed.2007.01.037
dc.description.source Web of Science
dc.identifier.wos WOS:000245344200039



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