Glomerular damage as a predictor of renal allograft loss

Glomerular damage as a predictor of renal allograft loss

Autor Moscoso-Solorzano, Grace Tamara Autor UNIFESP Google Scholar
Câmara, Niels Olsen Saraiva Autor UNIFESP Google Scholar
Franco, Marcello Fabiano de Autor UNIFESP Google Scholar
Araújo, Sergio Autor UNIFESP Google Scholar
Ortega, Francisco Gabriel Google Scholar
Pacheco-Silva, Alvaro Autor UNIFESP Google Scholar
Mastroianni Kirsztajn, Gianna Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hospital Universitario Central de Asturias Servicio de Nefrología
Fundación Renal Iñigo Alvarez de Toledo Y Fundación Carolina-BBVA
Universidade de São Paulo (USP)
Resumo Interstitial fibrosis and tubular atrophy (IF/TA) are the most common cause of renal graft failure. Chronic transplant glomerulopathy (CTG) is present in approximately 1.5-3.0% of all renal grafts. We retrospectively studied the contribution of CTG and recurrent post-transplant glomerulopathies (RGN) to graft loss. We analyzed 123 patients with chronic renal allograft dysfunction and divided them into three groups: CTG (N = 37), RGN (N = 21), and IF/TA (N = 65). Demographic data were analyzed and the variables related to graft function identified by statistical methods. CTG had a significantly lower allograft survival than IF/TA. In a multivariate analysis, protective factors for allograft outcomes were: use of angiotensin-converting enzyme inhibitor (ACEI; hazard ratio (HR) = 0.12, P = 0.001), mycophenolate mofetil (MMF; HR = 0.17, P = 0.026), hepatitis C virus (HR = 7.29, P = 0.003), delayed graft function (HR = 5.32, P = 0.016), serum creatinine ≥1.5 mg/dL at the 1st year post-transplant (HR = 0.20, P = 0.011), and proteinuria ≥0.5 g/24 h at the 1st year post-transplant (HR = 0.14, P = 0.004). The presence of glomerular damage is a risk factor for allograft loss (HR = 4.55, P = 0.015). The presence of some degree of chronic glomerular damage in addition to the diagnosis of IF/TA was the most important risk factor associated with allograft loss since it could indicate chronic active antibody-mediated rejection. ACEI and MMF were associated with better outcomes, indicating that they might improve graft survival.
Palavra-chave Kidney transplantation
Chronic allograft nephropathy
Glomerulonephritis
Transplant glomerulopathy
Idioma Inglês
Data de publicação 2010-06-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 43, n. 6, p. 557-564, 2010.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 557-564
Fonte http://dx.doi.org/10.1590/S0100-879X2010007500039
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000278872700006
SciELO S0100-879X2010000600006 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/5790

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