Determination of renal function in long-term heart transplant patients by measurement of urinary retinol-binding protein levels

Determination of renal function in long-term heart transplant patients by measurement of urinary retinol-binding protein levels

Autor Chinen, Rogerio Autor UNIFESP Google Scholar
Câmara, Niels Olsen Saraiva Autor UNIFESP Google Scholar
Nishida, Sonia Autor UNIFESP Google Scholar
Silva, Marcelo de Souza Autor UNIFESP Google Scholar
Rodrigues, Dirceu Almeida 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)
Resumo Significant improvements have been noted in heart transplantation with the advent of cyclosporine. However, cyclosporine use is associated with significant side effects, such as chronic renal failure. We were interested in evaluating the incidence of long-term renal dysfunction in heart transplant recipients. Fifty-three heart transplant recipients were enrolled in the study. Forty-three patients completed the entire evaluation and follow-up. Glomerular (serum creatinine, creatinine clearance measured, and creatinine clearance calculated) and tubular functions (urinary retinol-binding protein, uRBP) were re-analyzed after 18 months. At the enrollment time, the prevalence of renal failure ranged from 37.7 to 54% according to criteria used to define it (serum creatinine> or = 1.5 mg/dL and creatinine clearance <60 mL/min). Mean serum creatinine was 1.61 ± 1.31 mg/dL (range 0.7 to 9.8 mg/dL) and calculated and measured creatinine clearances were 67.7 ± 25.9 and 61.18 ± 25.04 mL min-1 (1.73 m²)-1, respectively. Sixteen of the 43 patients who completed the follow-up (37.2%) had tubular dysfunction detected by increased levels of uRBP (median 1.06, 0.412-6.396 mg/dL). Eleven of the 16 patients (68.7%) with elevated uRBP had poorer renal function after 18 months of follow-up, compared with only eight of the 27 patients (29.6%) with normal uRBP (RR = 3.47, P = 0.0095). Interestingly, cyclosporine trough levels were not different between patients with or without tubular and glomerular dysfunction. Renal function impairment is common after heart transplantation. Tubular dysfunction, assessed by uRBP, correlates with a worsening of glomerular filtration and can be a useful tool for early detection of renal dysfunction.
Palavra-chave Renal function
Urinary retinol-binding protein
Heart transplant
Graft survival
Chronic renal failure
Idioma Inglês
Data de publicação 2006-10-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 39, n. 10, p. 1305-1313, 2006.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1305-1313
Fonte http://dx.doi.org/10.1590/S0100-879X2006001000006
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000242173300006
SciELO S0100-879X2006001000006 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/3282

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