PMID- 8669103
OWN - NLM
STAT- MEDLINE
DCOM- 19960802
LR  - 20190713
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 61
IP  - 11
DP  - 1996 Jun 15
TI  - Serum C-reactive protein. A useful and economical marker of immune activation in 
      renal transplantation.
PG  - 1593-600
AB  - This study investigated whether serial daily measurements of serum C-reactive 
      protein (sCRP) in 187 renal allograft recipients could help discriminate episodes 
      of renal dysfunction due to rejection or cyclosporine (CsA) nephrotoxicity and 
      help adjust immunosuppression in the early posttransplant period. Excellent 
      primary graft function was associated with an initial peak of sCRP on day 2 after 
      transplant (median, 29 microg/ml; range, 4 to >200 microg/ml) with a return to 
      <20 microg/ml in all patients by day 5 (median, 7 microg/ml; range, 2-19 
      microg/ml). Stable graft function (mean creatinine, 155 microg/ml) was 
      accompanied by a median sCRP of 4 microg/ml (range, 1-19 microg/ml). In 30 
      episodes of rejection responsive to methylprednisolone, sCRP was initially 
      significantly raised to a median of 49 microg/ml (P<0.001) but fell rapidly in 
      response to treatment to a median of 11 microg/ml and continued to fall. In 19 
      episodes of rejection unresponsive to methylprednisolone, median initial sCRP 
      levels were significantly higher (P<0.001) at 119 microg/ml and were still at a 
      median of 77 microg/ml at the end of the treatment. Twenty-four patients in whom 
      renal dysfunction was associated with CsA nephrotoxicity showed no increase in 
      sCRP concentrations; median sCRP concentrations remained at <5 microg/ml 
      throughout the episodes. A similar pattern was seen in patients with acute 
      tubular necrosis. Serial sCRP measurements provide economical and reproducible 
      evidence of immune activation, help discriminate renal dysfunction due to CsA 
      nephrotoxicity or rejection, and allow appropriate modification of 
      immunosuppressive therapy.
FAU - Harris, K R
AU  - Harris KR
AD  - Wessex Regional Renal and Transplant Unit, Portsmouth Hospitals NHS Trust, St. 
      Mary's Hospital, Portsmouth, United Kingdom.
FAU - Digard, N J
AU  - Digard NJ
FAU - Lee, H A
AU  - Lee HA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Biomarkers)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - AYI8EX34EU (Creatinine)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers
MH  - Blood Transfusion
MH  - C-Reactive Protein/*analysis
MH  - Creatinine/blood
MH  - Cyclosporine/adverse effects
MH  - Graft Rejection
MH  - Humans
MH  - Kidney/drug effects
MH  - Kidney Transplantation/*immunology
MH  - Methylprednisolone/therapeutic use
MH  - Middle Aged
MH  - Transplantation, Homologous
MH  - Urinary Tract Infections/etiology
EDAT- 1996/06/15 00:00
MHDA- 1996/06/15 00:01
CRDT- 1996/06/15 00:00
PHST- 1996/06/15 00:00 [pubmed]
PHST- 1996/06/15 00:01 [medline]
PHST- 1996/06/15 00:00 [entrez]
AID - 10.1097/00007890-199606150-00008 [doi]
PST - ppublish
SO  - Transplantation. 1996 Jun 15;61(11):1593-600. doi: 
      10.1097/00007890-199606150-00008.