Clinicopathologic Features and Risk Factors of Proteinuria in Transplant Glomerulopathy

Frontiers in Medicine

article

Qiang Zhang¹  Birgit Rudolph³  Kaiyin Wu³  Klemens Budde¹  Danilo Schmidt¹  Fabian Halleck¹  Michael Duerr¹  Marcel G. Naik¹  Manuel Mayrdorfer¹  Wiebke Duettmann¹  Frederick Klauschen³ 

[1] Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin;Department of Organ Transplant, The First Affiliated Hospital, Sun Yat-sen University;Department of Pathology, Charité-Universitätsmedizin Berlin

关键词: blood pressure;    graft function;    kidney transplantation;    proteinuria;    renal biopsy;   

DOI  :  10.3389/fmed.2021.666319

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Transplant glomerulopathy (TG) is one of the main causes of post-transplant proteinuria (PU). The features and possible risk factors for proteinuria in TG patients are uncertain. Methods: We investigated all patients who had biopsy-proven TG from 2000 to 2018 in our center. The clinical and histological data were compared between two groups with or without PU (cut-off = 0.3 g/day). Spearman correlation analysis was used to evaluate the relationship between PU and pathological changes. The risk factors for PU in TG patients were determined by multivariable logistic regression analysis. Results: One hundred and twenty-five (75.76%) of all enrolled 165 TG patients had proteinuria ≥0.3 g/day at the time of biopsy. TG patients' PU level was significantly correlated with Banff lesion score cg (ρ = 0.247, P = 0.003), and mm (ρ = 0.257, P = 0.012). Systolic blood pressure ≥140 mmHg (OR 2.72, 95% CI 1.04–7.10, P = 0.041), diastolic blood pressure ≥90 mmHg (OR 4.84, 95% CI 1.39–16.82, P = 0.013), peak PRA ≥5% (OR 6.47, 95% CI 1.67–25.01, P = 0.007), positive C4d staining (OR 4.55, 95% CI 1.29–16.11, 0.019), tacrolimus-based regimen (OR 3.5, 95% CI 1.28–9.54, P = 0.014), and calcium channel blocker usage (OR 4.38, 95% CI 1.59–12.09, P = 0.004) were independent risk factors for PU. Conclusions: Proteinuria is common in TG patients. systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, peak PRA ≥5%, positive C4d staining, tacrolimus-based regimen, and calcium channel blocker usage are associated with proteinuria in TG patients.

【 授权许可】

CC BY