Journal
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 6, Issue 7, Pages 1786-1793Publisher
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.01310211
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Funding
- Canadian Institutes of Health Research [200504MCT-146229-RAB]
- Astellas Canada
- Roche Canada
- Novartis Canada
- Wyeth Canada
- Genzyme Canada
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Proteinuria is a common problem encountered in the treatment of renal transplant recipients, occurring in up to 45% of patients. Proteinuria from native kidneys falls rapidly after renal transplantation, and persistent or worsening proteinuria is usually indicative of allograft pathology. Biopsy studies of transplant patients with proteinuria have confirmed that transplant-specific diagnoses (transplant glomerulopathy, interstitial fibrosis and tubular atrophy, and acute rejection) are more commonly found than other proteinuric conditions, such as glomerulonephritis. As in the nontransplant setting, proteinuria is associated with worse clinical outcomes, including an increased risk for death, cardiovascular events, and graft loss. Blockade of the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers will reduce proteinuria, but the long-term effect of these medications on patient and graft survival remains unknown. Clin J Am Soc Nephrol 6: 1786-1793, 2011. doi: 10.2215/CJN.01310211
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