PROTEINURIE NACH NIERENTRANSPLANTATION

Abstract

During the initial 50 days following transplantation of a cadaver kidney into 8 patients, determinations of 7 individual protein clearances were performed twice a week. This, the first posttransplantation investigation of single protein clearances utilizing unconcentrated urine, was made possible by the highly sensitive electroimmunodiffusion method of Laurell. The following results were obtained: kidney implantation was immediately followed by glomerulo-tubular proteinuria. In patients exhibiting good transplant tolerance the tubular proteins disappeared from the urine by the 43rd day at the latest; on the other hand, excretion of the glomerular proteins transferrin and albumin continued. In patients without complications the proteinuria was already highly selective by the 7th day (70°); in 5 of 8 patients there was a change in the proteinuria pattern during the rejection crisis: glomerulo-tubular proteinuria occurred three times and glomerular proteinuria twice. In two of these cases there was a change in the selectivity; patients with good tolerance showed plasma pre-albumin levels which increased as a function of the time lapse since transplantation; the plasma concentration of retinol-binding protein did not vary following transplantation and remained at 16.8±2.8mg% in patients with uneventful course and at 18.5±4.9mg% in patients with transplant rejection reactions, both values being markedly above the norm (4.7±1.1mg%, [1 SD]).