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Proteinuria >0.5 g/d, a prevalent prognostic factor for patient and graft survival in kidney transplantation
Author(s) -
Cantarovich Félix,
Martinez Frank,
Heguilen Ricardo,
Thervet Eric,
MamzerBruneel MarieFrance,
Gonzalez Claudio,
Legendre Christophe
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01043.x
Subject(s) - medicine , renal function , proportional hazards model , proteinuria , hazard ratio , urology , creatinine , kidney transplantation , transplantation , survival analysis , risk factor , gastroenterology , kidney , confidence interval
Cantarovich F, Martinez F, Heguilen R, Thervet E, Mamzer Bruneel M‐F, Gonzalez C, Legendre C. Proteinuria >0.5 g/d, a prevalent prognostic factor for patient and graft survival in kidney transplantation.
Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01043.x
© 2009 John Wiley & Sons A/S. Abstract: Proteinuria >0.5 g/d (HP) and serum creatinine (Scr) >120 μmol/L (HSC) at three months, two and five yr were compared as prognostic factors in kidney transplantation. We retrospectively analyzed 454 first transplants (follow‐up: 100 ± 3.2 months). Donor/recipient age, sex, panel reactive antibody (PRA), HLA mismatches, cold ischemia time, delayed graft function, acute rejection, blood pressure and its treatment, diabetes and anti‐calcineurin use were also evaluated. Cox proportional hazard regression with time‐dependent covariates to control for potentially confounding factors was used to analyze survival. The Kaplan–Meier product–limit estimate for survival according to urine protein excretion (≤ or >0.5 g/d) or Scr (≤ or >120 μmol/L) along with the log‐rank test for all comparisons were computed. Statistical significance was set with p‐value < 0.05. Results: HSC is a prognostic factor of graft survival (HR: 2.54; 95% CI: 1.98–3.10; p < 0.01) only at five yr, but it does not predict mortality at any period. HP at three months (HR: 2.07; 95% CI: 1.70–2.43; p < 0.001) and at two yr 3.03 (2.54–3.51; p < 0.001) significantly predicts graft failure. HP at two yr is the prevailingly prognostic factor of patient survival in kidney transplantation (HR: 3.30; 95% CI: 1.94–5.62; p < 0.0001).