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Urinary acidification in renal allografts.

G Graziani, A de Vecchi, C Ponticelli

    Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
    |January 1, 1975
    PubMed
    Summary
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    Kidney transplant rejection can be detected early by monitoring urinary acid excretion. A decrease in H+ excretion often precedes rising creatinine levels, aiding in early diagnosis of renal allograft rejection.

    Area of Science:

    • Nephrology
    • Transplantation immunology

    Background:

    • Renal allograft recipients face risks of rejection.
    • Early detection of rejection is crucial for graft survival.

    Purpose of the Study:

    • To investigate urinary acid excretion as an early marker for renal allograft rejection.
    • To assess the relationship between acidification impairment and serum creatinine levels during rejection episodes.

    Main Methods:

    • Measured urinary acid excretion in 35 human renal allograft recipients.
    • Monitored patients in the early post-transplant period and two months later.
    • Observed 17 rejection episodes.

    Main Results:

    • A significant decrease in renal total net H+ excretion was observed in 16 out of 17 rejection episodes.

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  • This urinary acidification impairment preceded increases in serum creatinine.
  • Minimal changes in blood pH and chloride levels were noted.

    • Conclusions:

    • Early impairment of urinary acidification is a potential indicator of renal allograft rejection.
    • Acidification defects may result from ischemic changes associated with rejection.
    • Monitoring urinary acid excretion can support early clinical diagnosis of rejection.