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2017年4月17日星期一

Why does Proteinuria Happen after Renal Transplantation


In some cases, the patients may find proteinuria after renal transplantation. Usually, proteinuria comes as a warning risk factor that affect prognsois in the patient. As is suggested by recent researches, among transplant recipients accompanied by proteinuria, 5 year survival rate of transplant kidney in is 58.9%, which is much lower than the 85.6% rate in those without urine proteins. Survival rate for transplanted kidney drops to 42.4% in case proteinuria exists for over 12 months. This has driven awareness for early preventing proteinuria.
Why Diabetic Nephropathy Patients Would Appear Proteinuria?
What is the incidence rate of proteinuria after renal transplantation? In very first days after renal transplantation, transient proteinuria may occur as a result of ischemic reperfusion injury. In this condition, the foams in urine will disappear in a short time with renal blood infusion recovering. Urine protein output>1000mg/d happen at an average 23.7 months after the surgery, among those cases, 46.4% patients are manifested as transient proteinuria, while persistent proteinuria occurs in 53.6% cases. Recipients with normal renal function and slightly elevated blood pressure are prone to microalbuminuria, but as the urine protein level is small, the urine routine often shows – or +-.
Why Nephrotic Syndrome Has Proteinuria?
Besides proteinuria, some post-transplantation patients also gradually develop such other renal symptoms, such as high blood pressure, swelling, hematuria, etc. Usually, the relapse of primary disease is the common cause. Take IgA Nephropathy for instance. Its average recurrence rate after transplantation is 26-46%. In FSGS, the relapse rate reaches further up to 50%. If a FSGS patient experiences heavy proteinuria and high blood pressure within months after transplantation, he/she may lose the new kidney within one year. In Mesangial Proliferative Nephritis, graft recurrence chance approaches 80%, and the onset is usually proteins in urine. Almost all cases of recurrence in Membranous Nephropathy is manifested as heavy proteinuria, and commonly the onset is 10 months after transplantation.
Do patients need to regulate their immunosuppressive medicine treatment after transplantation? Appropriate application of suppressive drugs remits repulsion damage to the new kidney. If the medicines are not used properly, the patient is also prone to secondary kidney injury. If proteinuria occurs, you will need to consult your doctor to make a suitable treatment plan. In addition, anti-hypertensive medicine treatment will also help for reducing protein amount in urine and delaying kidney progression.
What Food Can Help Patients Reduce Proteinuria?

How do the patients control proteinuria? After renal transplantation, the patients should control their body weight and avoid overfatigue to protect the kidneys. Low sodium diet is necessary to keep blood pressure under ideal control. Moreover, you will need to restrict dietary protein consumption and keep in good nutrition status. Experiment on animals has proven to effectively reduce proteinuria and slow down renal interstitial fibrosis and tubular atrophy.

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