Creatinine Clearance and Proteinuria as Early Markers of Kidney Graft Survival

Influence of renal function on long-term graft survival and patient survival in renal transplant recipients

“…The literature review identified a total of 11 studies that examined the relationship between GFR and overall graft survival [7][8][9][10][11][12][13][14][15][16][17] , and 17 studies examined death-censored graft survival 7,8,[10][11][12][15][16][17][18][19][20][21][22][23][24][25][26] . Four studies did not state whether graft survival was censored for death or not (Table 1) [27][28][29][30] .…”

“…Nine of these studies were categorized as large scale (!500 patients) 7,8,10,12,15,18,20,23,25 , and the 13 studies that performed significance testing on the link between GFR and death-censored graft loss reported a significant association between reduced GFR and an elevated risk for death-censored graft loss 7,8,10,12,15,[17][18][19][20]22,23,25,26 . As expected, the magnitude of the relationship between declining GFR and graft survival was increased when censored for death.…”

Cystatin C and albuminuria as predictors of long‐term allograft outcomes in kidney transplant recipients

“…Mean follow‐up time was 5.6 ± 1.7 yr (range 1.1–8.9) yr. During this time, five patients died, and 18 patients developed graft failure, resulting in crude mortality and graft failure (censored for death) rates of 3.9% and 14.1%, respectively. Graft loss causes were clinically diagnosed chronic allograft dysfunction (7 patients), biopsy‐proven interstitial fibrosis/tubular atrophy , transplant glomerulopathy , and BK nephropathy . Patient characteristics are listed in Table .…”

“… reported that different Cr‐based GFR equations showed similar utility in predicting mortality and graft failure after renal transplantation. Larger studies have demonstrated that one‐yr Cr and Cr‐based GFR estimates are independently related not only to kidney allograft survival but also to patient survival . Moreover, the risk of DCGL increases progressively with lower GFR values, and even a modest decline in allograft function (40–59 mL/min/1.73 m 2 ) increases the risk of graft loss in years 1 to 3 by 31% .…”

“…Obviously, the most analyzed surrogate marker has been renal function. One-yr renal function estimated by serum creatinine (Cr) or Cr-derived equations is a predictor of further graft loss, although with variable predictive ability (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). On the other hand and similar to non-transplanted chronic kidney disease (CKD) patients, proteinuria and albuminuria have been associated with worse kidney survival in kidney transplant recipients (14).…”