The group hypothesized that pediatric transplant recipients achieve normal urinary protein to creatinine ratios by 60 days post-transplant in the absence of early recurrent disease.

They retrospectively reviewed 108 consecutive pediatric renal transplant recipients at Stanford. They found that 30% of the patients who were eligible had ? 1 urinary protein to creatinine ratio obtained during the first 60 days post transplant. The mean age at transplant was 13.9 ± 4.2 years. Mean weekly urinary protein to creatinine ratio values were not lower than 0.2 until the ninth post-transplant week. The group also found that there was no difference in post-transplant proteinuria between the nephrectomized and non-nephrectomized transplant recipients. Their experience with a single patient with proven focal segmental glomerulosclerosis recurrence suggests that normative urinary protein to urinary creatinine ratio data may be useful in early identification of patients experiencing disease recurrence. They performed a univariate correlation demonstrating that urinary protein to urinary creatinine ratios negatively correlated with serum albumin levels as well as the number of days post-transplant.

The group concluded that independent of primary diagnosis, proteinuria persists throughout the first 60 days in most pediatric transplant recipients. They also stated that it decreases relative to time post-transplant.

Annabelle N Chua, Steven R Alexander, Minnie M Sarwal, Maria Millan, Oscar Salvatierra Jr, Peter D. Yorgin .

Pediatric Transplantation 10(8): 957-961, December 2006.

Written by Pasquale Casale, MD, a Contributing Editor with UroToday.

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