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https://doi.org/10.1111/j.1432-2277.2008.00801.x
Title: | Factors associated with proteinuria in renal transplant recipients treated with sirolimus | Authors: | Liew, Adrian Chiang, Gilbert SC Vathsala, Anantharaman |
Keywords: | Science & Technology Life Sciences & Biomedicine Surgery Transplantation cyclosporine proteinuria renal transplantation sirolimus statins CHRONIC ALLOGRAFT NEPHROPATHY ENDOTHELIAL GROWTH-FACTOR CALCINEURIN-INHIBITORS KIDNEY-TRANSPLANTATION REDUCTASE INHIBITOR NEPHROTIC SYNDROME HEAVY PROTEINURIA ACUTE REJECTION BLOOD-PRESSURE RAPAMYCIN |
Issue Date: | 1-Mar-2009 | Publisher: | WILEY | Citation: | Liew, Adrian, Chiang, Gilbert SC, Vathsala, Anantharaman (2009-03-01). Factors associated with proteinuria in renal transplant recipients treated with sirolimus. TRANSPLANT INTERNATIONAL 22 (3) : 313-322. ScholarBank@NUS Repository. https://doi.org/10.1111/j.1432-2277.2008.00801.x | Abstract: | Although sirolimus (SRL) use in renal allograft recipients (RTX) is associated with improved renal function, proteinuria develops in a significant proportion. 48 SRL-treated RTX were evaluated for development of proteinuria and stratified by level of proteinuria after SRL therapy. The Proteinuria Group (n = 25, 52.1%) had new-onset proteinuria or >25% increase in proteinuria following SRL conversion; the Nonproteinuria Group had stable proteinuria <0.5 g/day throughout. There was a higher proportion of male RTX and female donors to male recipients in the Proteinuria Group, (24% vs. 10%, P = 0.008). Calcineurin inhibitor- and statin usage were significantly higher in the Nonproteinuria Group (8% vs. 17%, P = 0.046; 28% vs. 83%, P < 0.001 respectively) whereas biopsy-proven acute rejection was higher in the Proteinuria Group (68% vs. 33%, P = 0.037). SDS-PAGE analysis of urine from 23 RTX in the Proteinuria Group demonstrated glomerular proteinuria in 100% and tubular proteinuria in 87%. While male gender and gender mismatch may impact on glomerular proteinuria through inadequate nephron dose and subsequent hyperfiltration, concurrent cyclosporine use may mitigate the development of proteinuria in SRL-treated patients, through afferent arteriolar vasoconstriction. Glomerular injury occurring following acute rejection may further contribute to glomerular proteinuria. Statins, through their anti-inflammatory and anti-fibrotic effects, may protect against development of proteinuria. © 2008 The Authors. | Source Title: | TRANSPLANT INTERNATIONAL | URI: | https://scholarbank.nus.edu.sg/handle/10635/229443 | ISSN: | 0934-0874 1432-2277 |
DOI: | 10.1111/j.1432-2277.2008.00801.x |
Appears in Collections: | Staff Publications Elements |
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