title: Chronic kidney disease is still present after renal transplantation with excellent function.
abstract: According to a k/DOQI work group, chronic kidney disease (CKD) can be present also in subjects with glomerular filtration rate (GFR) >90 mL/min or a serum creatinine (sCr) below 1.3 mg/dL. The aim of this study was to document the prevalence of clinical or biologic abnormalities among 190 cadaveric renal transplant patients with excellent and stable renal function at 6 months after transplantation as well as 5 years later. The recipients were 82 women and 108 men of mean age at transplantation of 44.56 +/- 11.73 years. All patients were on Neoral-based immunosuppression with at least 5-year follow-up. Mean sCr was 1.18 +/- 0.2 mg/dL. Mean GFR was 78.57 +/- 27.06 mL/min. Systolic blood pressure was >130 mm Hg in 56.6%, although 78.3% of patients were on antihypertensive therapy; 34.3% were anemic; 75.4% had serum cholesterol >200 mg/dL; 62.2% had serum triglyceride levels >170 mg/dL. Serum intact parathyroid hormone >100 pg/mL was observed in 38% of patients and 43% were on vitamin D supplementation, and 11.4% had developed posttransplant diabetes mellitus. With respect to controls, von Willebrand factor was higher in 81.2% (P < .0001; RR = 11); serum homocysteine levels in 75% (P < 0.001; RR = 7.61); PAI-1 in 37.5% (P = .0009; RR = 4). At 5 years posttransplantation we observed an overall improvement in these abnormalities. The vast majority of renal transplant patients with excellent graft function belong to stage 1 of CKD being affected by hypertension, dyslipidemia, anemia, and residual hyperparathyroidism. Markers of endothelial dysfunction were largely abnormal, a condition that could predispose to cardiovascular events.
authors.affiliation: Renal Unit, Careggi University Hospital, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bertoni
authors.forename: A
authors.initials: A
authors.lastname: Rosati
authors.forename: A
authors.initials: A
authors.lastname: Larti
authors.forename: C
authors.initials: C
authors.lastname: Merciai
authors.forename: M
authors.initials: M
authors.lastname: Zanazzi
authors.forename: G
authors.initials: G
authors.lastname: Rosso
authors.forename: M
authors.initials: M
authors.lastname: Gallo
authors.forename: R
authors.initials: R
authors.lastname: Marcucci
authors.forename: M
authors.initials: M
authors.lastname: Salvadori
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology; D001794:Blood Pressure; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine