Glomerular damage as a predictor of renal allograft loss

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dc.contributor.authorMoscoso-Solorzano, Grace Tamara [UNIFESP]
dc.contributor.authorCâmara, Niels Olsen Saraiva [UNIFESP]
dc.contributor.authorFranco, Marcello Fabiano de [UNIFESP]
dc.contributor.authorAraújo, Sergio [UNIFESP]
dc.contributor.authorOrtega, Francisco Gabriel
dc.contributor.authorPacheco-Silva, Alvaro [UNIFESP]
dc.contributor.authorMastroianni Kirsztajn, Gianna [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionHospital Universitario Central de Asturias Servicio de Nefrología
dc.contributor.institutionFundación Renal Iñigo Alvarez de Toledo Y Fundación Carolina-BBVA
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2015-06-14T13:41:44Z
dc.date.available2015-06-14T13:41:44Z
dc.date.issued2010-06-01
dc.description.abstractInterstitial 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.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina Disciplina de Nefrologia
dc.description.affiliationHospital Universitario Central de Asturias Servicio de Nefrología
dc.description.affiliationFundación Renal Iñigo Alvarez de Toledo Y Fundación Carolina-BBVA
dc.description.affiliationUniversidade de São Paulo Instituto de Ciências Biomédicas IV Departamento de Imunologia
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Patologia
dc.description.affiliationUnifespUNIFESP, Depto. de Medicina Disciplina de Nefrologia
dc.description.affiliationUnifespUNIFESP, Depto. de Patologia
dc.description.sourceSciELO
dc.format.extent557-564
dc.identifierhttp://dx.doi.org/10.1590/S0100-879X2010007500039
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 43, n. 6, p. 557-564, 2010.
dc.identifier.doi10.1590/S0100-879X2010007500039
dc.identifier.fileS0100-879X2010000600006.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2010000600006
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/5790
dc.identifier.wosWOS:000278872700006
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectKidney transplantationen
dc.subjectChronic allograft nephropathyen
dc.subjectGlomerulonephritisen
dc.subjectTransplant glomerulopathyen
dc.titleGlomerular damage as a predictor of renal allograft lossen
dc.typeinfo:eu-repo/semantics/article
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