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Identification of clinical and histopathologic risk factors for diminished renal function 2 years posttransplant.

P Nickerson, J Jeffery, J Gough, R McKenna, P Grimm, M Cheang and D Rush
JASN March 1998, 9 (3) 482-487; DOI: https://doi.org/10.1681/ASN.V93482
P Nickerson
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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J Jeffery
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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J Gough
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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R McKenna
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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P Grimm
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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M Cheang
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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D Rush
Department of Medicine, University of Manitoba, Winnipeg, Canada.
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Abstract

The aim of this study was to identify early clinical and pathologic variates that independently predict diminished renal allograft function at 24 mo posttransplant. A clinical pathologic data base was prospectively derived from 71 patients in whom protocol renal biopsies were performed at 1, 2, 3, 6, and 12 mo posttransplant. The major end point was the 24-mo serum creatinine. Variates correlating independently (r2 = 0.67) with the 24-mo serum creatinine were the chronic biopsy scores (months 3 and 6), late rejections (months 4 to 6), cyclosporin A (CsA) levels (months 1 to 2), and delayed graft function. The adjusted odds ratio (OR) and 95% confidence interval (CI) for having a serum creatinine > or = 130 mumol/L at 24 mo increased for every year the donor age increased (OR = 1.07; 95% CI, 1.02 to 1.13; range, 9 to 55) or for each late rejection episode (OR = 5.9; 95% CI, 1.7 to 20.1), whereas a mean CsA level > 300 micrograms/L from months 1 to 3 was protective (OR = 0.07; 95% CI, 0.01 to 0.43). Variates correlating independently (r2 = 0.53) with the change in serum creatinine from 6 to 24 mo (delta Cr6-24) were the chronic biopsy scores at months 3 and 6. The adjusted OR of the delta Cr6-24 rising > or = +20 mumol/L increased for every year the donor age increased (OR = 1.09; 95% CI, 1.02 to 1.16; range 9 to 56) or when the 6-mo chronic biopsy score was > or = 2 (OR = 6.6; 95% CI, 1.2 to 36.4). An estimate of the relative risk for diminished renal function at 2 yr can be assigned within 6 mo of transplant based on chronic pathology, late acute rejections, CsA levels, and donor age.

  • Copyright © 1998 by American Society of Nephrology
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Journal of the American Society of Nephrology
Vol. 9, Issue 3
1 Mar 1998
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Identification of clinical and histopathologic risk factors for diminished renal function 2 years posttransplant.
P Nickerson, J Jeffery, J Gough, R McKenna, P Grimm, M Cheang, D Rush
JASN Mar 1998, 9 (3) 482-487; DOI: 10.1681/ASN.V93482

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Identification of clinical and histopathologic risk factors for diminished renal function 2 years posttransplant.
P Nickerson, J Jeffery, J Gough, R McKenna, P Grimm, M Cheang, D Rush
JASN Mar 1998, 9 (3) 482-487; DOI: 10.1681/ASN.V93482
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Cited By...

  • Multicentre randomised controlled trial protocol of urine CXCL10 monitoring strategy in kidney transplant recipients
  • Angiotensin II Blockade in Kidney Transplant Recipients
  • Untreated Rejection in 6-Month Protocol Biopsies Is Not Associated with Fibrosis in Serial Biopsies or with Loss of Graft Function
  • Protocol Transplant Biopsies: An Underutilized Tool in Kidney Transplantation
  • Protocol Transplant Biopsies: Are They Really Needed?
  • Protocol Transplant Biopsies in Kidney Allografts: Why and When Are They Indicated?
  • No Difference in Degree of Interstitial Sirius Red-Stained Area in Serial Biopsies from Area under Concentration-over-Time Curves-Guided Cyclosporine versus Tacrolimus-Treated Renal Transplant Recipients at One Year
  • Predictors of Renal Allograft Histologic Damage Progression
  • Computerized Image Analysis of Sirius Red-Stained Renal Allograft Biopsies as a Surrogate Marker to Predict Long-Term Allograft Function
  • The Impact of Repeated Subclinical Acute Rejection on the Progression of Chronic Allograft Nephropathy
  • Protocol Core Needle Biopsy and Histologic Chronic Allograft Damage Index (CADI) as Surrogate End Point for Long-Term Graft Survival in Multicenter Studies
  • Enzyme-Linked Immunosorbent Spot Assay Analysis of Peripheral Blood Lymphocyte Reactivity to Donor HLA-DR Peptides: Potential Novel Assay for Prediction of Outcomes for Renal Transplant Recipients
  • Telomere Shortening in Kidneys with Age
  • Effect of Increasing Baseline Immunosuppression on the Prevalence of Clinical and Subclinical Rejection: A Pilot Study
  • Clinical Rejection Is Distinguished from Subclinical Rejection by Increased Infiltration by a Population of Activated Macrophages
  • Rethinking Chronic Allograft Nephropathy: The Concept of Accelerated Senescence
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