Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients.
BACKGROUND: Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and ath...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2007
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| _version_ | 1797085838696251392 |
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| author | van Ree, R Oterdoom, L de Vries, A Gansevoort, RT van der Heide, J van Son, W Ploeg, R de Jong, P Gans, R Bakker, S |
| author_facet | van Ree, R Oterdoom, L de Vries, A Gansevoort, RT van der Heide, J van Son, W Ploeg, R de Jong, P Gans, R Bakker, S |
| author_sort | van Ree, R |
| collection | OXFORD |
| description | BACKGROUND: Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. METHODS: In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of <1 year (n = 31) were excluded from analysis. RESULTS: A total of 575 patients participated at a median (interquartile range) time of 5.9 (2.6-11.3) years post-transplantation. Median time of follow-up was 3.0 (2.4-3.4) years. Changes in serum creatinine during follow-up were -0.45 (-4.83-4.76) micromol/l/year in 172 subjects with CRP <1.0 mg/l, 1.04 (-3.36-6.12) micromol/l/year in 184 subjects with CRP 1.0-3.0 mg/l and 2.34 (-3.33-9.07) micromol/l/year in 219 subjects with CRP >3.0 mg/l (P < 0.05 for comparison of the three groups). Proteinuria (P = 0.003), CMV IgG titre (P = 0.01), donor age (P = 0.01), CRP concentration (P = 0.02), recipient age (P = 0.02) and recipient gender (P = 0.047) were independently associated with change in serum creatinine during follow-up in a multivariate analysis. CONCLUSIONS: Elevated levels of CRP independently predict accelerated deterioration of graft function in renal transplant recipients >1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP. |
| first_indexed | 2024-03-07T02:13:36Z |
| format | Journal article |
| id | oxford-uuid:a17945d9-bde3-4933-8037-5303e73327dd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:13:36Z |
| publishDate | 2007 |
| record_format | dspace |
| spelling | oxford-uuid:a17945d9-bde3-4933-8037-5303e73327dd2022-03-27T02:13:28ZElevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a17945d9-bde3-4933-8037-5303e73327ddEnglishSymplectic Elements at Oxford2007van Ree, ROterdoom, Lde Vries, AGansevoort, RTvan der Heide, Jvan Son, WPloeg, Rde Jong, PGans, RBakker, S BACKGROUND: Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. METHODS: In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of <1 year (n = 31) were excluded from analysis. RESULTS: A total of 575 patients participated at a median (interquartile range) time of 5.9 (2.6-11.3) years post-transplantation. Median time of follow-up was 3.0 (2.4-3.4) years. Changes in serum creatinine during follow-up were -0.45 (-4.83-4.76) micromol/l/year in 172 subjects with CRP <1.0 mg/l, 1.04 (-3.36-6.12) micromol/l/year in 184 subjects with CRP 1.0-3.0 mg/l and 2.34 (-3.33-9.07) micromol/l/year in 219 subjects with CRP >3.0 mg/l (P < 0.05 for comparison of the three groups). Proteinuria (P = 0.003), CMV IgG titre (P = 0.01), donor age (P = 0.01), CRP concentration (P = 0.02), recipient age (P = 0.02) and recipient gender (P = 0.047) were independently associated with change in serum creatinine during follow-up in a multivariate analysis. CONCLUSIONS: Elevated levels of CRP independently predict accelerated deterioration of graft function in renal transplant recipients >1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP. |
| spellingShingle | van Ree, R Oterdoom, L de Vries, A Gansevoort, RT van der Heide, J van Son, W Ploeg, R de Jong, P Gans, R Bakker, S Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title_full | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title_fullStr | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title_full_unstemmed | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title_short | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients. |
| title_sort | elevated levels of c reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients |
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