Abstract
We conducted this study to evaluate the risk factors for proteinuria in renal transplant patients. We reviewed the records of the active renal transplant patients at two large transplant centers in Riyadh and Jeddah in Saudi Arabia, transplanted between January 1979 and November 1998. The recipients were grouped according to the presence and magnitude of proteinuria: group I; from zero-0.3 g/L, group II; from 0.4-1.0 g/L, group III; more than one g/L. The records of 340 patients were reviewed in this study. The mean age of the study patients was 39.7 years and the mean duration following transplantation was 82.2 months. There were 209 (61.5%) patients in group I, 92 (27.1%) patients in group II and 39 (11.5%) patients in group III. There was no significant difference among the three groups in terms of mean age, mean duration after transplantation, type of donor (living-related and unrelated, or cadaver), rate of re-transplantation (8.2%), prevalence of hypertension while on dialysis (66.6%), etiology of original renal disease, incidence of acute rejection in the first year, occurrence of diabetes after transplantation (30.6%), or mean serum level of cholesterol (5.9 mmol/L). In comparison to the other groups, group I had significantly more females (44.5 %), more patients with blood pressure within normal limits with or without treatment (56% versus 38% and 17% respectively), lower mean serum creatinine (125 mu mol/L versus 149 and 173 mu mol/L respectively), higher mean cyclosporine dose (3.28 versus 2.7 and 2.73 mg/kg/day respectively), higher mean prednisolone dose (0.15 mg/kg/day) and less frequency of abnormal electrocardiogram (10% versus 22% and 25% respectively). We conclude that the prevalence of post-transplant proteinuria is high in our study patients. Also, our study suggests that proteinuria may be a marker of renal dysfunction and cardiovascular disease in this group of patients. Further studies are required including allograft histology to delineate better the causes and consequences of post-transplant proteinuria.