title: Proteinuria in Egyptian renal transplant recipients.
abstract: To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862). We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.
authors.forename: Essam
authors.initials: E
authors.lastname: Khedr
authors.forename: Magdy
authors.initials: M
authors.lastname: El Sharkawy
authors.affiliation: Renal Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Yasser
authors.initials: Y
authors.lastname: El Shahawy
authors.forename: Dawlat
authors.initials: D
authors.lastname: Sany
authors.forename: Hussein
authors.initials: H
authors.lastname: Sayed
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000150:complications; D006084:Graft Rejection / Q000150:complications; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012552:Schistosomiasis / Q000453:epidemiology