Rana proteinurija kao prediktor kronične nefropatije presatka

master's thesis

• Title (english): Early proteinuria as a predictor of chronic allograft nephropathy
• Author: Nikola Zagorec
• Mentor: Mladen Knotek (mentor)
• Committee member: Draško Pavlović (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Mladen Knotek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Jedan od vodećih uzroka zatajenja bubrežnog presatka su kronična nefropatija presatka koja se patohistološki manifestira intersticijskom fibozom i tubularnom atrofijom (IF/TA). Cilj rada je bio odrediti utjecaj rane proteinurije na progresiju IF/TA-e. U studiju je uključeno 75 bolesnika s transplantiranim bubregom ili bubregom i gušteračom koji su imali biopsije bubrega na dan transplantacije (Tx) i na 12 mj. te im je određivana proteinurija u periodu 1-3 mj. i 12 mj. poslije Tx. Prosječna progresija ci skora bila je 0.62±0.78, a ct skora 0.72±0.78, a prosječne vrijednosti proteinurija mjerene u razdoblju od kraja prvog do kraja trećeg mjeseca od implantacije su 0.26±0.21g/24h. U univarijantnoj analizi iznos rane proteinurije pozitivno korelira (R=0.37, p<0.001) s iznosom skora ci godinu dana po implantaciji kao i sa iznosom ct skora godinu dana po implantaciji (R=0.3, p<0.01). U multivarijatnoj analizi rana proteinurija ostaje neovisni prediktor progresije ci skora tijekom prve godine od Tx (p=0.02). AUC rane proteinurije za predikciju progresije intersticijske fibroze tijekom 1 god. od Tx je 0.7, p<0.01. Rana proteinurija je neovisan negativan prediktor progresije IF/TA-e.

Abstract (english)

One of major causes of kidney allograft failure is chronic allograft nephropathy which is manifest by interstitial fibrosis and tubular atrophy (IT/FA). Aim of study was to determine influence of early proteinuria on IT/FA progression. 75 patients with kidney and simultaneous kidney/pancreas transplantation who had kidney biopsies performed on the day of transplantation (Tx) and 12 months after and whose proteinuria was measured in period 1-3 months and 12 months after Tx were included in the study. Average ci score progression was 0.62±0.78 and ct score progression was 0.72±0.78 and average proteinuria values measured between 1 and 3 months after implantation were 0.26±0.21g/24h. Univariate analysis showed that early proteinuria positively correlates (R=0.37, p<0.001) with ci score 1 year after implantation and also with ct score 1 year after implantation (R=0.3, p<0.01). Multivariate analysis showed that early proteinuria remains independent predictor of ci score progression during first year after Tx (p=0.02). AUC of early proteinuria for prediction of interstitial fibrosis progression during 1 year after Tx is 0.7, p<0.01. Early proteinuria is independent negative predictor of IT/FA progression.

• Keywords: proteinurija; transplantacija bubrega; kronična nefropatija presatka; biopsija
• Keywords (english): proteinuria; kidney transplantation; chronic allograft nephropathy; biopsy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:603831
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-13 08:11:59