Investigation of the effect of proteinuria on the graft life time in the chronic rejection process in patients with renal transplantation

Proteinuria after renal transplantation is a frequently observed entity. Etiology of proteinuria can be examplified by renal lesions prior to transplantation, immunologic injury within allograft rejection process, ischemia reperfusion injury, chronic allograft nephropatia, new onset or recurrent glomerulonephritis, donor age, delayed hot and cold ischemia times, reflux nephropatia, renal vein thrombosis and acute rejection attacks. Early period proteinurias apperantly do not affect graft and patient survival however continuing proteinuria in longer periods have adverse effects on both graft and patient survival. While five year survival of patients without proteinuria is 80-85%, with proteinuria this number decreases to 50-60%. Also level of proteinuria has negative effects on both graft and patient survival. For instance while patients with a protenuria level of 2 g/d has a graft survival of 16.5 years, graft survival of patients with proteinuria levels above 2 g/d decreases to 5.6 years.