Avaliação da idade do doador e do tempo de isquemia fria como fatores de risco associados à presença de albuminúria no pós-transplante renal

Abstract

Introduction: The presence of albuminuria in post-kidney transplantation (KTx) has a variable incidence, being a good marker for detecting the lesion in the transplanted graft. Some pre-KTx factors such as donor age and cold ischemia time may influence this condition. Therefore, the aim of the study was to investigate the association of donor age and cold ischemia time for the appearance of albuminuria in the first year after KTx, evaluating the urinary albumin/creatinine ratio (ACR) as a potential predictor of renal function decline in post-KTx.

Methods: Longitudinal study that included 40 adult patients aged between 20 and 70 years, who received the first KTx between August 2015 and August 2017 at Hospital Universitario Onofre Lopes/EBSERH/UFRN. The patients were followed up at 3, 6, 9 and 12 months after KTx, with serum creatinine, ACR and estimated glomerular filtration rate being evaluated in each period. Clinical information on donors and recipients was taken from medical records.

Results: The patients evaluated had a mean age of 39.5 years, most were male (62.5%), and had glomerulonephritis (30%) and systemic arterial hypertension (30%) as the underlying disease. Most deceased donors (82.5%) had a mean age of 42 years and the mean cold ischemia time was 18.6 hours. There were positive correlations between the presence of albuminuria, donor age and cold ischemia time from 9 months after KTx.

Conclusion: Pre-KTx factors such as donor age and cold ischemia time may influence the appearance of albuminuria after 9 months post-KTx, contributing to the worsening of kidney function. Therefore, the control of these factors can favor the best quality of renal allograft function, increasing the survival of the renal graft and the patient.