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Slovenska pediatrija 2019; 26: 261-269

https://doi.org/

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Research article

PROTEINURIA IN CHILDREN AND ADOLESCENTS WITH RENAL GRAFTS

Jana Lobe Uršič
Otroški oddelek, Splošna bolnišnica Celje, Celje, Slovenija

Nina Battelino
Klinični oddelek za nefrologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Gregor Novljan
Klinični oddelek za nefrologijo Pediatrična klinika Univerzitetni klinični center Ljubljana in Katedra za pediatrijo Medicinska fakulteta, Univerza v Ljubljani Bohoričeva ulica 20, 1000 Ljubljana, Slovenija

Abstract

Introduction: Proteinuria is a common complication after kidney transplantation and affects graft and patient sur­vival. Our study aims to evaluate the prevalence and type of proteinuria in Slovenian pediatric renal graft recipients. Material and methods: Twenty children (median age at transplantation: 12.5 years, IQR: 6.2-14.0) were included in the study. There were slightly more boys (15/20, 65.2%). Pro­teinuria was assessed by the protein-to-creatinine ratio in a random urine sample (UPCR) and additional measurement of protein in a 24-hour urine collection in the case of UPCR > 20 g/mol. The type of proteinuria was determined by immu­nonephelometry using our hospital’s protocol. Fisher’s exact test and the Mann-Whitney U test were used for analysis. Results: Proteinuria was present in 35% of patients (7/20). Proteinuria was mild (mean: 321 mg/day, 95% CI: 180-463), and none of our patients had nephrotic range proteinuria. All patients had glomerular proteinuria, and only two had concomitant tubular proteinuria. When applying the .1-mi­croglobulin/albumin algorithm as proposed by Lun et al., tubular proteinuria was present in 50% of patients. Conclusions: Proteinuria was detected in a significant pro­portion of our patients. We could not confirm the pre­dominance of tubular proteinuria. The method used for proteinuria profiling is crucial when comparing results.

Key words: proteinuria, kidney transplantation, prevalence, children