Kidney Week

Abstract: FR-PO1156

Potential Prognostic Value of Immediate Postoperative Proteinuria Predicting Early Renal Outcome After Kidney Transplantation

Session Information

• Transplantation: Clinical - Post-Transplant Complications
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Park, Kyungho, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Kyungho Park,

• Park, Mee yeon, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Mee yeon Park,

• Boo, Hyo jin, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Hyo jin Boo,

• Jeon, Junseok, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Junseok Jeon,

• Lee, Jung eun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Jung eun Lee,

• Huh, Wooseong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Wooseong Huh,

• Kim, Yoon-Goo, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Yoon-Goo Kim,

• Kim, Dae joong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Dae joong Kim,

• Jang, Hye Ryoun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Hye Ryoun Jang,

Background

Proteinuria in kidney transplant recipients (KTRs) is associated with poor patient and allograft survival. However, the relationship between urinary protein to creatinine ratio (uPCR) or urinary albumin to creatinine ratio (uACR) during the immediate postoperative period and renal outcome of KTRs is yet to be determined.

Methods

This single center retrospective cohort study included 474 KTRs who underwent kidney transplantation (KT) from January 2014 to December 2017 and followed up for ≥ 1 year. After excluding patients without urine PCR and ACR within 7 days after KT and those without serum creatinine at 1 year after KT, a total of 353 KTRs were finally analyzed: living donor KT in 186 KTRs and, deceased donor KT (DDKT) in 167 KTRs. Immediate postoperative uPCR and uACR were measured within postoperative day 7. The primary outcome was estimated glomerular filtration rate (eGFR) at 1 year after KT. The secondary outcome was the incidence of delayed graft function (DGF) in DDKT recipients.

Results

Patients with higher eGFR (≥ 60 mL/min/1.73 m²) at 1 year after KT had lower uPCR (patients with ≥ 60 mL/min/1.73 m² vs. those with < 60 mL/min/1.73 m², median 810 ug/mgCr [IQR 500 - 1780] vs. median 1220 ug/mgCr [IQR 632 – 3905]; p = 0.007) and lower uACR (median 342 ug/mgCr [IQR 165 - 976] vs. median 613 ug/mgCr [IQR 284 - 2562]; p = 0.002) during the immediate postoperative period than those with lower eGFR. DDKT recipients with uPCR ≥ 3 mg/mgCr during the immediate postoperative period is associated with the higher incidence of DGF (DDKT recipients with uPCR ≥ 3 mg/mgCr vs. those with uPCR < 3 mg/mgCr, 30% vs. 13% [odds ratio 2.87]; p = 0.007), and lower eGFR before discharge (60 mL/min/1.73 m² [IQR 41 – 84] vs. 75 mL/min/1.73 m² [56 – 92]; p = 0.001) than those with uPCR < 3 mg/mgCr.

Conclusion

Our results suggest immediate postoperative uPCR as a potential predictor of early renal outcome in KTRs.