Profiling proteinuria in children after renal transplantation
Language English Country Germany Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Albuminuria physiopathology urine MeSH
- Alpha-Globulins analysis MeSH
- Algorithms MeSH
- Child MeSH
- Kidney Glomerulus physiopathology MeSH
- Transplantation, Homologous pathology MeSH
- Kidney Tubules physiopathology MeSH
- Humans MeSH
- Proteinuria complications physiopathology urine MeSH
- Cross-Sectional Studies MeSH
- Graft Rejection urine MeSH
- Serum Albumin analysis MeSH
- Kidney Transplantation adverse effects MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Alpha-Globulins MeSH
- alpha-1-microglobulin MeSH Browser
- Serum Albumin MeSH
Proteinuria is a common complication after renal transplantation (RTx). In adults, tubular proteinuria prevails and is associated with impaired graft survival. In the absence of studies on proteinuria profiling in transplanted children, we aimed at analyzing the types of proteinuria in transplanted children. Fifty-three children (11.8 years) were analyzed in a cross-sectional study. Morning urine was tested for total protein (PROT), albumin (ALB) and alpha-1-microglobulin (AMG). The type of proteinuria was assessed by the alpha-1-microglobulin/albumin algorithm (AAA): [AAA = AMG x 100/(AMG+ALB]. Median PROT, ALB, and AMG (in mg/mmol creatinine) were 20.0, 3.8, and 4.9, respectively. Pathological total proteinuria (>22 mg protein/mmol creatinine) was found in 47% of children (25/53). Only 20% of patients with pathological total proteinuria (5/25) had glomerular proteinuria, whereas 80% (20/25) had tubular proteinuria. Three of five children with glomerular proteinuria had chronic allograft nephropathy. Both AMG and albuminuria negatively correlated with the estimated glomerular filtration rate (eGFR) (p = 0.021 and 0.003, respectively). In conclusion, tubular proteinuria was present in 80% of children post-RTx and may be associated with impaired graft function; glomerular proteinuria is associated mainly with chronic allograft nephropathy.
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Management of proteinuria in the transplanted patient
