Late Graft Loss pp 31-37 | Cite as
Is there any relationship between the early glomerular filtration rate and late graft dysfunction in renal transplantation?
Abstract
Late graft dysfunction remains the main cause of graft loss in renal transplantation in spite of improvements in shortterm renal allograft survival and advances in immunosuppressive therapy [1]. Chronic rejection is often an unpredictable outcome in renal transplantation, although many previous publications have tried to identify risk factors [2, 3]. However, most publications have focused on variables in univariate statistical analysis without taking into account potential confounding factors. Both immune and nonimmune mechanisms have been implicated in the pathogenesis of chronic rejection [4], Among the nonimmunological mechanisms, hyperfiltration could be a cause of chronic graft failure [5], although clear human functional data in renal transplantation are lacking.
Keywords
Glomerular Filtration Rate Renal Allograft Renal Transplant Patient Plasma Creatinine Chronic RejectionPreview
Unable to display preview. Download preview PDF.
References
- 1.Matas AJ, Burke JF, Devault GA, Monaco A, Pirsch J. Chronic rejection. J. Am. Soc. Nephrol. 1994; 4: S23–S29.PubMedGoogle Scholar
- 2.Almond PS, Matas A, Gillingham K et al. Risk factors for chronic rejection in renal allograft recipients. Transplantation 1993; 55: 752–756.PubMedCrossRefGoogle Scholar
- 3.Riggio RR, Haschemeyer R, Suthanthiran M et al. Predictability of renal allograft failure time in long term survivors: a hypothesis. Transplant. Proc. 1985; 17: 2311–2313.Google Scholar
- 4.Massy ZA, Guijarro C, Wiederkehr MR, Ma JZ, Kasiske BL. Chronic renal allograft rejection: immunologic and non immunologic risk factors. Kidney Int. 1996; 49: 518–524.PubMedCrossRefGoogle Scholar
- 5.Terasaki PI, Koyama H, Cecka M, Gjerston D. The hyperfiltration hypothesis in human renal transplantation. Transplantation 1994; 57: 1450–1454.PubMedGoogle Scholar
- 6.Paul LC, Häyry P, Foegh M et al. Diagnostic criteria of chronic rejection/accelerated graft atherosclerosis of heart and kidney transplants. Proposal from the Fourth Alexis Carrel Conference on chronic rejection and accelerated arteriosclerosis in transplanted organs. Transplant. Proc. 1993; 25: 2022–2023.PubMedGoogle Scholar
- 7.Solez K, Axelsen RA, Benediktsson H et al. International standardization of criteria for the histological diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology. Kidney Int. 1993; 44: 411–422.PubMedCrossRefGoogle Scholar
- 8.Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31–41.CrossRefGoogle Scholar
- 9.Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; i: 307–310.CrossRefGoogle Scholar
- 10.Levey AS. Measurement of renal function in chronic renal disease. Kidney Int. 1990; 38: 167–184.PubMedCrossRefGoogle Scholar
- 11.Walser M, Drew HH, Guldan JL. Prediction of glomerular filtration rate from serum creatinine concentration in advanced chronic renal failure. Kidney Int. 1993; 44: 1145–1148.PubMedCrossRefGoogle Scholar
- 12.Modena FM, Hostetter TH, Salahudden AK, Najarian JS, Matas AJ, Rosenberg ME. Progression of kidney disease in chronic renal transplant rejection. Transplantation 1991; 52: 239–244.PubMedCrossRefGoogle Scholar
- 13.Walser M, Drew HH, Lafrance ND. Reciprocal creatinine slopes often give erroneous estimates of progression of chronic renal failure. Kidney Int. 1989; 27: S81-S85.Google Scholar
- 14.Nyberg G, Norden G, Svalander C, Blohmé I. Long term renal allograft function. Transpl. Int. 1994; 7: 284–287.PubMedCrossRefGoogle Scholar
- 15.Kasiske BL, Heim-Duthoy KL, Tortorice KL, Rao KV. The variable nature of chronic declines in renal allograft function. Transplantation 1991; 51: 330–334.PubMedCrossRefGoogle Scholar
- 16.Paul LC, Fellström B. Chronic vascular rejection of the heart and the kidney — Have rational treatment options emerged? Transplantation 1992; 53: 1169–1179.PubMedCrossRefGoogle Scholar