Proteinuria among renal transplant patients and its relation to hepatitis C virus and graft outcome: a single center experience.
OBJECTIVE
Chronic hepatitis C virus has been associated with glomerular disease in native and transplanted kidneys. Reports suggest that hepatitis C virus-infected renal recipients may develop de novo glomerulonephritis. We evaluated the presence of hepatitis C virus at transplant, the occurrence of proteinuria in Egyptian renal transplant patients, and its possible link with graft survival.


METHODS
Three hundred seventeen patients with end-stage renal disease receiving transplants in Mansoura Urology and Nephrology Center were retrospectively evaluated between 2000 and 2003. Their sera were assayed for anti-hepatitis C virus antibodies at transplant. The relation between hepatitis C virus and development of posttransplant proteinuria was evaluated, along with possible effects of proteinuria on long-term graft survival.


RESULTS
Two hundred seventy-three recipients fulfilled the inclusion criteria, 169 were positive and 104 were negative for hepatitis C virus-antibodies by ELISA. Mean duration of posttransplant follow-up was 87.73 +/- 26.79 and 84.29 +/- 28.55 months for both groups. Groups were comparable regarding the incidence and quantity of hepatitis C virus positive patients and 0.4 g/d (P = .09 of proteinuria). In both hepatitis C virus-positive and negative groups, those with nephrotic range proteinuria showed worse graft survival (P = .001) and higher frequency of chronic allograft nephropathy (P = .05) compared with nonproteinuric patients.


CONCLUSIONS
There is a high prevalence of hepatitis C virus in our end-stage renal disease patients awaiting renal transplant. The incidence and quantity of proteinuria is similar in both hepatitis C virus-positive and hepatitis C virus-negative transplant recipients. Nephrotic range proteinuria is associated significantly with a higher incidence of chronic allograft nephropathy. Independent from serology, it is associated with poorer graft outcome.
Sabry
Alaa
A
Nephrology and Internal Medicine Department, Mansoura Urology and Nephrology Center, Mansoura University, Egypt. asabry2040@yahoo.comr
D000328:Adult; D016009:Chi-Square Distribution; D004534:Egypt / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006085:Graft Survival; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D018937:Hepatitis C Antibodies