Urinary protein/creatinine ratio as an indicator of allograft function following live related donor renal transplantation.
In a study of 656 urine specimens from 53 consecutive recipients of live related donor renal allografts we found an excellent correlation between the protein content of 24-h urines and protein/creatinine ratio (Up/Ucr) in overnight urine samples. Using this ratio, we evaluated proteinuria up to 180 days after renal transplantation (overnight urine samples analysed, n = 2745). Heavy proteinuria in the immediate post-operative period had no prognostic significance. Eighty-nine percent of all clinically observed acute rejection episodes were accompanied by an increase over baseline of Up/Ucr; in 56.5% of these episodes elevation of Up/Ucr preceded that of serum creatinine. However, as a marker of rejection the usefulness of this parameter was limited owing to large number of false positive elevations. In 50 recipients whose grafts survived for more than 3 mth, proteinuria was graded into minimal, moderate and heavy. Renal function at the end of six months was good in all patients who exhibited proteinuria with Up/Ucr less than 100 mg/mmol creatinine. Persistent proteinuria with Up/Ucr above 100 mg/mmol preceded significant deterioration of graft function. Therefore, a protein-creatinine ratio of 100 mg/mmol can be considered as an apparent cut-off to differentiate stable from deteriorating graft function in long term evaluation of transplant recipients.
D000293:Adolescent; D000328:Adult; D003404:Creatinine / Q000652:urine*; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine*
D007166:Immunosuppressive Agents; D003404:Creatinine