Screening for proteinuria in kidney transplant recipients

Abstract

ACR and PCR are probably equivalent in predicting adverse events. Conventional dipstick is also predictive but does not appear to be as sensitive.

Posttransplantation Proteinuria

“…Using receiver operating characteristic curves analysis, the c-statistic for PCR was 0.82 (95% CI 0.75 to 0.90; P Ͻ 0.001) and for the ACR was 0.83 (95% CI 0.76 to 0.90; P Ͻ 0.001) (35). Both the PCR and ACR performed better than the urine dipstick (c ϭ 0.76; 95% CI 0.66 to 0.86; P Ͻ 0.001) (38). This analysis suggests that spot measures of proteinuria, which are simple and convenient for the patient, are associated with graft survival in a manner similar to the standard 24-hour urine collection.…”

“…In a singlecenter cross-sectional study, 500 kidney transplant recipients were assessed to evaluate the association among ACR, PCR, and urine dipstick protein with the end point of death-censored graft loss (38). After 2.98 years of followup, all three measures of proteinuria were significantly associated with the outcome (38).…”

“…In a singlecenter cross-sectional study, 500 kidney transplant recipients were assessed to evaluate the association among ACR, PCR, and urine dipstick protein with the end point of death-censored graft loss (38). After 2.98 years of followup, all three measures of proteinuria were significantly associated with the outcome (38). Using receiver operating characteristic curves analysis, the c-statistic for PCR was 0.82 (95% CI 0.75 to 0.90; P Ͻ 0.001) and for the ACR was 0.83 (95% CI 0.76 to 0.90; P Ͻ 0.001) (35).…”

Evaluation and Management of Proteinuria After Kidney Transplantation

“…10,12,15,30,49,[54][55][56][57][58][59][60][61][62][63][64][65][66] These studies have been reviewed and are presented in Table 3. Studies by Fontan et al, 54 Amer et al, 10 and Kang et al 59 demonstrated that even a modest increase in protein excretion was associated with graft loss after adjusting for renal function.…”

Clinical and histological predictors of long-term kidney graft survival

“…Moreover, both cardiovascular and non-cardiovascular deaths are increased in patients with proteinuria [22,24]. Recent studies using the urinary protein-creatinine ratio confirm these findings, and indicate that spot measures of proteinuria can be used for renal transplant monitoring [25].…”