The diagnostic value of protein clearances in rejection of human renal allografts.
The relative clearances of transferrin, haptoglobin, IgG, and IgA were used as a diagnostic test for detection of acute rejection episodes after renal transplantation, using an automated immunoprecipitin reaction. Thirty-six out of 40 rejections were predicted by 0--5 days. The sensitivity and specificity were 90% and 98%, respectively. The predictive value of a positive diagnostic test was 86% and of a negative 99%. False positives caused by fever and urinary obstruction could probably be excluded by the finding of an increased urinary excretion of beta2-microglobulin prior to the increased relative clearance of transferrin, haptoglobin, IgG and IgA. This would improve the predictive value of a positive test to 95%. Daily or more frequent protein clearance determinations should be performed in renal transplant patients, since the method used was easy, rapid and suited for sequential analysis, and the procedure was without risk for the patient.
D000293:Adolescent; D000328:Adult; D001798:Blood Proteins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D006084:Graft Rejection; D006242:Haptoglobins / Q000652:urine; D006801:Humans; D007070:Immunoglobulin A / Q000652:urine; D007074:Immunoglobulin G / Q000652:urine; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014168:Transferrin / Q000652:urine; D014184:Transplantation, Homologous
D001798:Blood Proteins; D006242:Haptoglobins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D014168:Transferrin; D003404:Creatinine