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Glomerular Enlargement Assessed by Paired Donor and Early Protocol Renal Allograft Biopsies
Author(s) -
Alperovich Gabriela,
Maldonado Rafael,
Moreso Francesc,
Fulladosa Xavier,
Grinyó Josep M.,
Serón Daniel
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00392.x
Subject(s) - medicine , transplantation , urology , biopsy , chronic allograft nephropathy , nephropathy , renal biopsy , creatinine , renal function , kidney transplantation , kidney disease , pathology , endocrinology , diabetes mellitus
The aim of the study was to evaluate the evolution of glomerular volume 4 months after transplantation. Mean glomerular volume (Vg) was estimated according to the Weibel and Gomez method in a donor and a protocol biopsy done at 139 ± 58 d in 41 stable grafts. Biopsies were also evaluated according to the Banff schema. Vg increased after transplantation from 4.1 ± 1.4 to 5.1 ± 2.4 × 10 6 μ 3 (p = 0.02). In patients with chronic allograft nephropathy in the protocol biopsy (n = 14), the Vg enlargement was −0.3 ±× 10 6 μ 3 while in patients without chronic allograft nephropathy (n = 27), glomerular enlargement was 1.6 ± 2.1 × 10 6 μ 3 (p = 0.01). There was a negative association between glomerular volume in the donor biopsy and glomerular enlargement after transplantation (R =− 0.34, p = 0.03). Multivariate regression analysis confirmed that Vg in the donor biopsy and chronic allograft nephropathy in the protocol biopsy were independent predictors of glomerular enlargement after transplantation (R = 0.48, p = 0.01). Moreover, Vg in the protocol biopsy correlated with creatinine clearance at the time of biopsy (R = 0.38, p = 0.01). Glomeruli enlarge after transplantation and glomerular volume after 4 months correlates with creatinine clearance, suggesting that glomerular enlargement is a necessary condition for renal adaptation to the recipient. Glomerular enlargement is impaired in patients with chronic allograft nephropathy.