Nr. 3 - 3. Quartal 1994

Alpha-1-Microglobulin as a Prognostic Marker of Renal Function after Transplantation

J. Hoyer, R. Preuss, L. Fricke, J. Steinhoff

Persistent proteinuria after renal transplantation usually is related to an unfavourable prognosis. In a retrospective analysis of long term transplants we had detected that azathioprine (Aza) treated patients mostly showed a normal proteinuria whereas ciclosporin (CsA) treated patients had pathological concentrations of albumin, IgG and alpha-1-microglobulin (a1M) (p < 0.01). A1M seemed to be the most valuable marker. Based on that experiences we prospectively analyzed 44 kidney recipients treated by a triple therapy of Aza, CsA and steroids. A1M was measured by an immunoluminometric technique 4 resp. 12 months after transplantation. The a1M concentration was related to the creatinine (Cr) excretion. We found that patients with an elevated a1M excretion after 4 months (a1M > 42mg/g Cr) had a significantly (p < 0.001) lower renal function (serum Cr 161umol/l) after 12 months compared to patients with a normal a1M proteinuria (a1M < 42mg/g Cr) (serum Cr 126umol/l). We conclude that a1M is a valid prognostic marker for estimating the 1- year graft function.

Keywords:

Kidney transplantation, urine proteins, alpha-1-microglobulin, ciclosporin toxicity

Kurztitel:

Hoyer, J. et al. (1994) TxMed 3:189

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