Urinary Albumin Excretion and the Risk of Graft Loss and Death in Proteinuric and Non-proteinuric Renal Transplant Recipients
Article first published online: 11 JAN 2007
American Journal of Transplantation
Volume 7, Issue 3, pages 618–625, March 2007
How to Cite
Halimi, J.-M., Buchler, M., Al-Najjar, A., Laouad, I., Chatelet, V., Marlière, J.-F., Nivet, H. and Lebranchu, Y. (2007), Urinary Albumin Excretion and the Risk of Graft Loss and Death in Proteinuric and Non-proteinuric Renal Transplant Recipients. American Journal of Transplantation, 7: 618–625. doi: 10.1111/j.1600-6143.2007.01665.x
- Issue published online: 11 JAN 2007
- Article first published online: 11 JAN 2007
- Revised manuscript October 23 2006
- renal transplantation;
- urinary albumin excretion
Background: Microalbuminuria and macroalbuminuria constitute risk factors for ESRD and death in non-transplanted populations. Whether microalbuminuria (especially in non-proteinuric patients) and macroalbuminuria constitute risk factors for graft loss and death is presently unknown in renal transplantation.
Methods: We retrospectively assessed the association between urinary albumin excretion (UAE) and ESRD and death in renal transplantation.
Results: UAE was measured in 616 (397 proteinuric; 219 non-proteinuric patients) renal transplant recipients. They were grafted for 62 months (range: 6–192). During the 40 months (3.7–99) thereafter, 31 patients underwent dialysis and 32 died.
Microalbuminuria (vs. normoalbuminuria) and macroalbuminuria (vs. microalbuminuria) were powerful risk factors for graft loss [OR: 14.25 (2.88–52.3) and 16.41 (7.46–36.0), respectively, both p < 0.0001], even after adjustments on renal function and diabetes.
Among the 219 non-proteinuric patients, microalbuminuria (vs. normoalbuminuria) was a significant risk factor for graft loss [OR: 23.09 (1.93–276.4), p = 0.0132].
Both microalbuminuria (vs. normoalbuminuria) [OR: 5.55 (2.43–12.66), p < 0.0001] and macroalbuminuria (vs. microalbuminuria) [OR: 4.12 (1.65–10.29), p = 0.0024] were predictive of death.
Conclusions: Microalbuminuria and macroalbuminuria are powerful independent predictors of ESRD and death. Microalbuminuria is a risk factor for graft loss even in non-proteinuric patients. UAE provides additional information on renal and patient prognosis as compared to proteinuria and renal function.