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Proteinuria after kidney transplantation: its relation to hepatitis C virus and graft outcome

Alaa Sabry1, Rashad Hassan, Ihab Mahmoud

  • 1Department of Nephrology, Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. asabry20@yahoo.com

Iranian Journal of Kidney Diseases
|April 14, 2009
PubMed

Insights

Hepatitis C Virus (HCV) infection is common in Egyptian kidney transplant recipients. While HCV doesn't increase proteinuria, nephrotic-range proteinuria significantly worsens graft survival and increases chronic allograft nephropathy.

Area of Science:

  • Nephrology
  • Virology
  • Transplantation Immunology

Background:

  • Chronic Hepatitis C Virus (HCV) infection is linked to kidney disease in native and transplanted kidneys.
  • Egyptian kidney transplant patients exhibit a high prevalence of HCV infection.

Purpose of the Study:

  • To evaluate HCV infection at transplantation and its association with proteinuria.
  • To determine the impact of proteinuria on long-term graft survival in kidney transplant recipients.

Main Methods:

  • Retrospective study of 273 Egyptian end-stage renal disease patients transplanted between 1993-1996.
  • Assay for anti-HCV antibodies at transplantation.
  • Evaluation of post-transplantation proteinuria and its effect on graft survival.

Main Results:

  • 61.9% of kidney recipients were positive for anti-HCV antibodies.
  • Proteinuria incidence (33% vs. 32%) and quantity (median 0.6 g/d vs. 0.4 g/d) were similar between HCV-positive and negative groups.
  • Nephrotic-range proteinuria correlated with worse graft survival (P < .001) and higher chronic allograft nephropathy (P = .03).

Conclusions:

  • High prevalence of HCV infection in end-stage renal disease patients awaiting kidney transplantation.
  • HCV infection does not increase the incidence or quantity of proteinuria.
  • Nephrotic-range proteinuria is an independent predictor of chronic allograft nephropathy and poorer graft outcomes.
Abstract

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