High-grade proteinuria as a cardiovascular risk factor in renal transplant recipients.

Autor: Guliyev O; Department of Nephrology, Baskent University, Ankara, Turkey., Sayin B; Department of Nephrology, Baskent University, Ankara, Turkey., Uyar ME; Department of Nephrology, Baskent University, Ankara, Turkey. Electronic address: mehtap94@yahoo.com., Genctoy G; Department of Nephrology, Baskent University, Ankara, Turkey., Sezer S; Department of Nephrology, Baskent University, Ankara, Turkey., Bal Z; Department of Nephrology, Baskent University, Ankara, Turkey., Demirci BG; Department of Nephrology, Baskent University, Ankara, Turkey., Haberal M; Department of General Surgery, Baskent University, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2015 May; Vol. 47 (4), pp. 1170-3.
DOI: 10.1016/j.transproceed.2014.10.062
Abstrakt: Background: Proteinuria is a marker of graft damage and is closely associated with a higher risk of morbidity, mortality, and cardiovascular disease in kidney transplant recipients (KTRs). Arterial stiffness is a well-known predictor of vascular calcification and systemic arteriosclerosis. In our study, we aimed to investigate the association between proteinuria and graft/patient survival and to determine whether proteinuria may be a predictor for cardiovascular disease in our KTR population.
Methods: Ninety KTRs (31 women; age, 38.7 ± 11 years, with 45.9 ± 9.6 months post-transplantation period) with normal graft functions in the 3 to 5 years of the post-transplantation period were enrolled. All patients were evaluated for their standard clinical (age, sex, and duration of hemodialysis) parameters. High-grade proteinuria was defined as proteinuria >500 mg/day in the 24-hour urine collection. All patients were evaluated by means of pulse-wave velocity (PWV) measurement at the initiation of the study.
Results: Patients were divided into 2 groups: group 1 (high-grade proteinuria) patients with ≥500 mg/24 hours (n = 30) and group 2 (low-grade proteinuria) patients with <500 mg/24 hours (n = 60). High-grade proteinuria was correlated with higher PWV measurements and lower estimated glomerular filtration levels. Proteinuria appears to precede the elevation of serum creatinine and thus may be a useful marker of renal injury and may also be a contributing factor on deterioration of the graft.
Conclusions: High-grade (>500 mg/day) proteinuria in KTRs is strongly associated with poor graft survival and increased risk of cardiovascular events. In our study, we proved the significant difference between high-grade and low-grade proteinuric patients, and we suggest 500 mg/day as the threshold of proteinuria in KTR population.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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