title: Chronic graft dysfunction in renal transplant patients: potential role of plasminogen activator inhibitor type 1.
abstract: BACKGROUND
  Chronic allograft nephropathy is the main cause of long-term kidney graft loss. The plasminogen activator inhibitor type 1 (PAI-1) is a potential fibrogenic molecule whose secretion is regulated by several metabolic, inflammatory, and genetic factors. We aimed to determine whether PAI-1 secretion in renal transplant patients is correlated with the decline in renal function after transplantation.
  
  
  METHODS
  Renal transplant patients (145 male/71 female) were included in the study 1-27 years after transplantation (median of follow-up: 7.35 years). At inclusion, routine clinical and biological data were collected, the 4G/5G polymorphism of the recipient PAI-1 gene was determined, and the PAI-1 plasma level was measured.
  
  
  RESULTS
  The mean rate of decline in renal function was -4.26+/-0.30 ml/min/year. By multiple linear regression analysis, the rate of decline in renal function was significantly correlated with proteinuria (P=0.0176), occurrence of late acute rejection episodes (P=0.0001), and PAI-1 plasma level (P=0.0051). In addition, PAI-1 plasma level was also significantly correlated with body mass index (P=0.038), insulin (P<0.0001), platelet count (P<0.0001), and fibrinogen (P=0.024). The PAI-1 gene polymorphism tested did not influence the rate of decline in renal function after transplantation nor the plasma level of PAI-1 antigen.
  
  
  CONCLUSIONS
  We conclude that PAI-1, whose secretion is determined in large part by metabolic and inflammatory factors, may be implicated in the rate of decline in renal function after transplantation.
authors: Service de Néphrologie A, Association Claude Bernard and INSERM U 489, Hôpital Tenon, Paris, France.
authors: Anis
authors: A
authors: Lahlou
authors: Marie-Noëlle
authors: MN
authors: Peraldi
authors: Eric
authors: E
authors: Thervet
authors: Antoine
authors: A
authors: Flahault
authors: Françoise
authors: F
authors: Delarue
authors: Florent
authors: F
authors: Soubrier
authors: Jérôme
authors: J
authors: Rossert
authors: Alexandre
authors: A
authors: Hertig
authors: Eric
authors: E
authors: Rondeau
mesh_terms: D000328:Adult; D000483:Alleles; D001483:Base Sequence; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood / Q000235:genetics*; D011110:Polymorphism, Genetic; D011183:Postoperative Complications / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D003404:Creatinine