Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria
AbstractAim The aim of the present study was to clarify the relationship between the Banff score of the 7-year protocol biopsy and the allograft outcome.Methods One-hundred-and-eighty-four patients received kidney transplantation from 2002 to 2008. We excluded patients aged <20 years at transplan...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2197499 |
| _version_ | 1797658514914541568 |
|---|---|
| author | Yoshihiro Itabashi Hideyo Oguchi Tetuo Mikami Noriyuki Kounoue Taichi Arai Kazunobu Shinoda Masaki Muramatsu Seiichiro Shishido Ken Sakai |
| author_facet | Yoshihiro Itabashi Hideyo Oguchi Tetuo Mikami Noriyuki Kounoue Taichi Arai Kazunobu Shinoda Masaki Muramatsu Seiichiro Shishido Ken Sakai |
| author_sort | Yoshihiro Itabashi |
| collection | DOAJ |
| description | AbstractAim The aim of the present study was to clarify the relationship between the Banff score of the 7-year protocol biopsy and the allograft outcome.Methods One-hundred-and-eighty-four patients received kidney transplantation from 2002 to 2008. We excluded patients aged <20 years at transplantation (n = 24), those who did not undergo a 7-year protocol biopsy (n = 66), and those who underwent for-cause biopsy (n = 5). Consequently, 89 patients who underwent a 7-year protocol biopsy were enrolled. We analyzed the relationship between the clinicopathological findings 7 years after transplantation and the estimated glomerular filtration rate (eGFR) change per year and allograft survival. Histological evaluation was performed using the Banff 2015 classification.Results Among the clinicopathological findings, each Banff mesangial matrix increase (mm) score ≥1 and proteinuria ≥1+ was independently associated with the eGFR decline per year during a median follow-up of 73 months. Furthermore, in the model of the clinicopathological findings including the presence of mm with proteinuria, mm ≥1 alone and mm ≥1 with proteinuria were each independently associated with the eGFR decline. The graft survival was significantly worse for those with mm ≥1 with proteinuria than those with mm ≥1 without proteinuria.Conclusion Among the 7-year protocol biopsy findings, the presence of mm alone and mm with proteinuria were each significant predictors of eGFR decline. The presence of both proteinuria and mm had a negative impact on graft survival. These results underscore the significance of the Banff mm score and proteinuria at the time of the 7-year protocol biopsy to predict the allograft outcome. |
| first_indexed | 2024-03-11T18:00:06Z |
| format | Article |
| id | doaj.art-78a1454c609342ea933b854c33899641 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-03-11T18:00:06Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-78a1454c609342ea933b854c338996412023-10-17T09:23:23ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2197499Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuriaYoshihiro Itabashi0Hideyo Oguchi1Tetuo Mikami2Noriyuki Kounoue3Taichi Arai4Kazunobu Shinoda5Masaki Muramatsu6Seiichiro Shishido7Ken Sakai8Department of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Pathology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineDepartment of Nephrology, Toho University Faculty of MedicineAbstractAim The aim of the present study was to clarify the relationship between the Banff score of the 7-year protocol biopsy and the allograft outcome.Methods One-hundred-and-eighty-four patients received kidney transplantation from 2002 to 2008. We excluded patients aged <20 years at transplantation (n = 24), those who did not undergo a 7-year protocol biopsy (n = 66), and those who underwent for-cause biopsy (n = 5). Consequently, 89 patients who underwent a 7-year protocol biopsy were enrolled. We analyzed the relationship between the clinicopathological findings 7 years after transplantation and the estimated glomerular filtration rate (eGFR) change per year and allograft survival. Histological evaluation was performed using the Banff 2015 classification.Results Among the clinicopathological findings, each Banff mesangial matrix increase (mm) score ≥1 and proteinuria ≥1+ was independently associated with the eGFR decline per year during a median follow-up of 73 months. Furthermore, in the model of the clinicopathological findings including the presence of mm with proteinuria, mm ≥1 alone and mm ≥1 with proteinuria were each independently associated with the eGFR decline. The graft survival was significantly worse for those with mm ≥1 with proteinuria than those with mm ≥1 without proteinuria.Conclusion Among the 7-year protocol biopsy findings, the presence of mm alone and mm with proteinuria were each significant predictors of eGFR decline. The presence of both proteinuria and mm had a negative impact on graft survival. These results underscore the significance of the Banff mm score and proteinuria at the time of the 7-year protocol biopsy to predict the allograft outcome.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2197499Kidney transplantation7-year protocol biopsyBanff scoreallograft survival |
| spellingShingle | Yoshihiro Itabashi Hideyo Oguchi Tetuo Mikami Noriyuki Kounoue Taichi Arai Kazunobu Shinoda Masaki Muramatsu Seiichiro Shishido Ken Sakai Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria Renal Failure Kidney transplantation 7-year protocol biopsy Banff score allograft survival |
| title | Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria |
| title_full | Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria |
| title_fullStr | Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria |
| title_full_unstemmed | Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria |
| title_short | Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria |
| title_sort | prognostic value of the 7 year protocol biopsy of adult kidney allografts impact of mesangiosclerosis and proteinuria |
| topic | Kidney transplantation 7-year protocol biopsy Banff score allograft survival |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2197499 |
| work_keys_str_mv | AT yoshihiroitabashi prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT hideyooguchi prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT tetuomikami prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT noriyukikounoue prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT taichiarai prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT kazunobushinoda prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT masakimuramatsu prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT seiichiroshishido prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria AT kensakai prognosticvalueofthe7yearprotocolbiopsyofadultkidneyallograftsimpactofmesangiosclerosisandproteinuria |