title: Early proteinuria after renal transplantation and allograft outcomes.
abstract: BACKGROUND
  Proteinuria is among the major and nonspecific sign of the renal disease. It is well known that late-onset proteinuria after renal transplantation has been associated with poor allograft outcomes and with mortality. Knowledge about the impact of early proteinuria on the various outcomes is limited. We have evaluated the utility of measuring early proteinuria in the management of pediatric renal transplant recipients.
  
  
  METHODS
  We analyzed the effect of proteinuria at 3 months of posttransplantation on allograft rejection, graft loss, and estimated glomerular filtration rate (GFR) at 3 years. Proteinuria was assessed using 24-hour urine protein excretion. Renal biopsy was performed when elevated creatinine levels were elevated during routine follow-up and an acute rejection episode was proven with biopsy.
  
  
  RESULTS
  Sixty-seven pediatric renal transplant recipients were included to the study. Mean follow-up time after transplantation was 48.8 ± 12.1 months. Thirty-nine recipients (58%) have proteinuria >500 mg/d. The relationship could not be shown between proteinuria at posttransplant month 3 and other outcomes parameters, such as graft loss and lower estimated GFR. A significant positive correlation between acute rejection and the proteinuria at posttransplant month 3 was shown.
  
  
  CONCLUSIONS
  We demonstrated that early proteinuria is a common finding in children after transplantation. Posttransplant early proteinuria cannot be used as a long-term prognostic marker of poor renal outcome. However, early proteinuria is associated with an high risk of acute rejection episodes. This would permit an opportunity for early intervention.
authors: Pediatric Nephrology Department, Baskent University, Ankara, Turkey. Electronic address: kaangulleroglu@yahoo.com.
authors: K
authors: K
authors: Gulleroglu
authors: Pediatric Nephrology Department, Baskent University, Ankara, Turkey.
authors: E
authors: E
authors: Baskin
authors: Pediatric Nephrology Department, Baskent University, Ankara, Turkey.
authors: U
authors: U
authors: Bayrakci
authors: General Surgery Department, Baskent University, Ankara, Turkey.
authors: A
authors: A
authors: Akdur
authors: General Surgery Department, Baskent University, Ankara, Turkey.
authors: G
authors: G
authors: Moray
authors: General Surgery Department, Baskent University, Ankara, Turkey.
authors: M
authors: M
authors: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology*; D051437:Renal Insufficiency / Q000601:surgery* / Q000652:urine*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003404:Creatinine