PMID- 24772400
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140428
LR  - 20211021
IS  - 2251-8363 (Print)
IS  - 2251-8819 (Electronic)
IS  - 2251-8363 (Linking)
VI  - 3
IP  - 2
DP  - 2014
TI  - Prevalence and risk factors for early chronic allograft nephropathy in a live 
      related renal transplant program.
PG  - 69-79
LID - 10.12860/jnp.2014.15 [doi]
AB  - BACKGROUND: Chronic allograft nephropathy (CAN) is a common cause of delayed 
      allograft failure throughout the world. Its prevalence and risk factors vary 
      depending on a number of factors. There is little information on the prevalence 
      and risk factors for early CAN in live related renal transplant patients. 
      OBJECTIVES: We aimed to determine the prevalence and the risk factors of early 
      CAN in our setup. PATIENTS AND METHODS: The study was conducted at Sindh 
      Institute of Urology & Transplantation (SIUT), Karachi, from 2002 to 2005 on 
      patients who had live related kidney transplantation and underwent at least one 
      allograft biopsy within 18 months of transplantation. The biopsies were performed 
      and prepared in accordance with established indications and guidelines. The Banff 
      97 classification and its updates were used to diagnose and categorize the biopsy 
      pathology. Patients were divided into two groups depending on the presence or 
      absence of CAN on biopsies. Following parameters were compared among the groups: 
      age, sex, human leukocyte antigen (HLA) match, immunosuppression used, acute 
      rejection (AR) episodes, urinary tract infections (UTIs), viral infections, 
      cyclosporine levels, early and late graft function monitored by serum creatinine. 
      RESULTS: A total of 164 patients fulfilled the study inclusion criteria. The mean 
      age of recipients and donors was relatively young. The majority of the donors 
      were siblings. The overall prevalence of CAN was 25.6% (42/164), between 3 and 18 
      months post transplantation. The median time to the appearance of CAN was 9 
      months post-transplant. The prevalence of CAN increased as post-transplant 
      duration increased. In 39 (92.8%) subjects, CAN was detected on the second or 
      subsequent graft biopsy. Only 3 (7.2%) patients showed CAN on the first graft 
      biopsy. The majority of cases belonged to moderate degree or grade II CAN. The 
      mean serum creatinine values were higher in the CAN group at the time of 
      discharge and all times post-transplantation. CONCLUSIONS: In conclusion, the 
      results show that serum creatinine at the time of discharge is a useful predictor 
      of later development of chronic changes in the allograft. Further studies are 
      needed to identify the risk factors for the early development of chronic changes 
      in living related renal transplant program.
FAU - Khan, Hamid
AU  - Khan H
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
FAU - Mubarak, Muhammed
AU  - Mubarak M
AD  - Department of Histopathology, Sindh Institute of Urology and Transplantation 
      (SIUT) Karachi, Pakistan.
FAU - Aziz, Tahir
AU  - Aziz T
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
FAU - Ahmed, Ejaz
AU  - Ahmed E
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
FAU - Fazal Akhter, Syed
AU  - Fazal Akhter S
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
FAU - Kazi, Javed
AU  - Kazi J
AD  - Department of Histopathology, Sindh Institute of Urology and Transplantation 
      (SIUT) Karachi, Pakistan.
FAU - Aa Naqvi, Syed
AU  - Aa Naqvi S
AD  - Department of Urology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
FAU - Ah Rizvi, Syed
AU  - Ah Rizvi S
AD  - Department of Urology, Sindh Institute of Urology and Transplantation (SIUT) 
      Karachi, Pakistan.
LA  - eng
PT  - Journal Article
DEP - 20140401
PL  - Iran
TA  - J Nephropathol
JT  - Journal of nephropathology
JID - 101611182
PMC - PMC3999587
OTO - NOTNLM
OT  - Delayed graft failure
OT  - Graft biopsy
OT  - Live related
OT  - Rejection
OT  - Transplant outcome
EDAT- 2014/04/29 06:00
MHDA- 2014/04/29 06:01
PMCR- 2014/01/01
CRDT- 2014/04/29 06:00
PHST- 2013/11/28 00:00 [received]
PHST- 2014/01/14 00:00 [accepted]
PHST- 2014/04/29 06:00 [entrez]
PHST- 2014/04/29 06:00 [pubmed]
PHST- 2014/04/29 06:01 [medline]
PHST- 2014/01/01 00:00 [pmc-release]
AID - 10.12860/jnp.2014.15 [doi]
PST - ppublish
SO  - J Nephropathol. 2014;3(2):69-79. doi: 10.12860/jnp.2014.15. Epub 2014 Apr 1.