Natural History of Proteinuria in Renal Transplant Recipients Developing De Novo Human Leukocyte Antigen Antibodies

 

Fortheringham J, Angel C, Goodwin J, Harmer AW, McKane WS

http://www.ncbi.nlm.nih.gov/pubmed/21519315

 

Patients with de novo DSA after renal transplantation showed significantly higher rates of acute rejection (74% vs. 41%), more graft losses (29% vs. 9%), lower glomerular filtration rate (GFR) at the time of antibody detection (31.8 ml/min/1.73m2 vs. 44.1 ml/min/1.73m2) and lower 3-year allograft survival (69.5 vs. 91.1%) than patients with NDSA. The GFR decline was -5.85 ml/min/1.73m2/year in DSA patients, which was significantly higher than the -3.21 ml/min/1.73m2/year and the -0.08 ml/min/1.73m2/year for the control patients. In regards to proteinuria, 45% of DSA positive patients had more than 3 g/L of protein in urine at the time of antibody detection compared to only 3% in NDSA  positive patients.