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dc.contributor.authorPark, Walter D.
dc.contributor.authorLarson, Timothy S.
dc.contributor.authorGriffin, Matthew D.
dc.contributor.authorStegall, Mark D.
dc.date.accessioned2018-09-20T16:21:10Z
dc.date.available2018-09-20T16:21:10Z
dc.date.issued2012-11-01
dc.identifier.citationPark, Walter D. Larson, Timothy S.; Griffin, Matthew D.; Stegall, Mark D. (2012). Identification and characterization of kidney transplants with good glomerular filtration rate at 1 year but subsequent progressive loss of renal function. Transplantation Journal 94 (9), 931-939
dc.identifier.issn0041-1337
dc.identifier.urihttp://hdl.handle.net/10379/13410
dc.description.abstractBackground. After the first year after kidney transplantation, 3% to 5% of grafts fail each year but detailed studies of how grafts progress to failure are lacking. This study aimed to analyze the functional stability of kidney transplants between 1 and 5 years after transplantation and to identify initially well-functioning grafts with progressive decline in allograft function. Methods. The study included 788 adult conventional kidney transplants performed at the Mayo Clinic Rochester between January 2000 and December 2005 with a minimum graft survival and follow-up of 2.6 years. The modification of diet in renal disease equation for estimating glomerular filtration rate (eGFR(MDRD)) was used to calculate the slope of renal function over time using all available serum creatinine values between 1 and 5 years after transplantation. Results. Most transplants demonstrated good function (eGFR(MDRD) >= 40 mL/min) at 1 year with positive eGFR(MDRD) slope between 1 and 5 years after transplantation. However, a subset of grafts with 1-year eGFR(MDRD) >= 40 mL/min exhibited strongly negative eGFR(MDRD) slope between 1 and 5 years suggestive of progressive loss of graft function. Forty-one percent of this subset reached graft failure during follow-up, accounting for 69% of allograft failures occurring after 2.5 years after transplantation. This pattern of progressive decline in estimated glomerular filtration rate despite good early function was associated with but not fully attributable to factors suggestive of enhanced antidonor immunity. Conclusions. Longitudinal analysis of serial estimated glomerular filtration ratemeasurements identifies initially well-functioning kidney transplants at high risk for subsequent graft loss. For this subset, further studies are needed to identify modifiable causes of functional decline.
dc.publisherOvid Technologies (Wolters Kluwer Health)
dc.relation.ispartofTransplantation Journal
dc.subjectkidney transplantation
dc.subjectglomerular filtration rate
dc.subjectgraft survival
dc.subjectchronic allograft nephropathy
dc.subjectproteinuria
dc.subjectallograft survival
dc.subjectgraft function
dc.subjectrecipients
dc.subjectmulticenter
dc.subjecthistology
dc.subjectefficacy
dc.subjecttherapy
dc.subjectsafety
dc.subjecttime
dc.titleIdentification and characterization of kidney transplants with good glomerular filtration rate at 1 year but subsequent progressive loss of renal function
dc.typeArticle
dc.identifier.doi10.1097/tp.0b013e3182692b70
dc.local.publishedsourcehttp://pdfs.journals.lww.com/transplantjournal/2012/11150/Identification_and_Characterization_of_Kidney.7.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1504480790685;payload|mY8D3u1TCCsNvP5E421JYK6N6XICDamxByyYpaNzk7FKjTaa1Yz22MivkHZqjGP4kdS2v0J76WGAnHACH69s21Csk0OpQi3YbjEMdSoz2UhVybFqQxA7lKwSUlA502zQZr96TQRwhVlocEp/sJ586aVbcBFlltKNKo+tbuMfL73hiPqJliudqs17cHeLcLbV/CqjlP3IO0jGHlHQtJWcICDdAyGJMnpi6RlbEJaRheGeh5z5uvqz3FLHgPKVXJzdGlb2qsojlvlytk14LkMXSCTy2MEk61Fuxxf1/TypFajkpMUj53GbZz/6SRhC9Gnp;hash|Ggckt+mBkLqItZ+8AS+jnA==
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