INFLUENCE OF PROTEINURIA ON LONG-TERM TRANSPLANT SURVIVAL IN KIDNEY-TRANSPLANT RECIPIENTS

Long-term prognosis in kidney transplant recipients depends on multipl e factors. To investigate whether mild proteinuria within the first 6 months following transplantation is a determinant of the long-term fun ction and survival of kidney transplants, 357 patients transplanted be tween 1980 and 1990 were retrospectively examined over a period of 5 y ears. 25.5% of the patients developed an early proteinuria between 0.2 5 and 1.0 g/day over 6 or more months. This group was well matched con cerning gender, age of recipient, underlying disease, time on hemodial ysis, donor age, cold ischemia time and HLA mismatches with the group without proteinuria (n = 266). Five-year transplant survival in the gr oup with proteinuria was 58.9% in contrast to 85.6% in recipients with out proteinuria. Intermittent proteinuria did not worsen long-term pro gnosis. Proteinuria of 12 months or longer further reduced 5-year tran splant survival to 42.6%. Over the whole observation period, serum cre atinine in recipients with proteinuria was about 0.5 mg/dl higher as c ompared with patients without proteinuria. No correlation between prot einuria and gender, age of recipient, duration of hemodialysis, age of donor, cold ischemia time and mismatches could be detected. In conclu sion, early proteinuria apparently is not due to established donor or recipient factors. However, there is a strong correlation of proteinur ia with worse transplant function and survival.