Functional and morphologic evaluation of kidney proximal tubuli and correlation with renal allograft prognosis

Functional and morphologic evaluation of kidney proximal tubuli and correlation with renal allograft prognosis

Autor Carvalho de Matos, Ana Cristina Autor UNIFESP Google Scholar
Saraiva Camara, Niels Olsen Autor UNIFESP Google Scholar
Franco de Oliveira, Ana Francisca Autor UNIFESP Google Scholar
Franco, Marcello F. Autor UNIFESP Google Scholar
Ribeiro Moura, Luiz Antonio Autor UNIFESP Google Scholar
Nishida, Sonia Autor UNIFESP Google Scholar
Pereira, Aparecido Bernardo Autor UNIFESP Google Scholar
Pacheco-Silva, Alvaro Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Albert Einstein Hosp
Universidade de São Paulo (USP)
Univ Jose Rosario Vellano
Resumo P>Renal transplant patients with stable graft function and proximal tubular dysfunction (PTD) have an increased risk for chronic allograft nephropathy (CAN). in this study, we investigated the histologic pattern associated with PTD and its correlation with graft outcome. Forty-nine transplant patients with stable graft function were submitted to a biopsy. Simultaneously, urinary retinol-binding protein (uRBP) was measured and creatinine clearance was also determined. Banff's score and semi-quantitative histologic analyses were performed to assess tubulointerstitial alterations. Patients were followed for 24.0 +/- 7.8 months. At biopsy time, mean serum creatinine was 1.43 +/- 0.33 mg/dl. Twelve patients (24.5%) had uRBP >= 1 mg/l, indicating PTD and 67% of biopsies had some degree of tubulointerstitial injury. At the end of the study period, 18 (36.7%) patients had lost renal function. uRBP levels were not associated with morphologic findings of interstitial fibrosis and tubular atrophy (IF/TA), interstitial fibrosis measured by Sirius red or tubulointerstitial damage. However, in multivariate analysis, the only variable associated with the loss of renal function was uRBP level >= 1 mg/l, determining a risk of 5.290 of loss of renal function (P = 0.003). Renal transplant patients who present PTD have functional alteration, which is not associated with morphologic alteration. This functional alteration is associated to progressive decrease in renal function.
Palavra-chave chronic allograft nephropathy
kidney transplantation
proximal tubular function
retinol-binding protein
surrogate marker
tubulointerstitial injury
Idioma Inglês
Financiador Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Roche Organ Transplantation Research Foundation-ROTRF
Data de publicação 2010-05-01
Publicado em Transplant International. Malden: Wiley-Blackwell Publishing, Inc, v. 23, n. 5, p. 493-499, 2010.
ISSN 0934-0874 (Sherpa/Romeo, fator de impacto)
Publicador Wiley-Blackwell
Extensão 493-499
Fonte http://dx.doi.org/10.1111/j.1432-2277.2009.01005.x
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000276409000012
Endereço permanente http://repositorio.unifesp.br/handle/11600/32486

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