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  • Title: Urinary protein analysis in the early detection of acute rejection episodes after renal transplantation in children.
    Author: Burghard R, Galaske RG, Offner G, Ehrich JH, Leititis JU, Brodehl J.
    Journal: Clin Nephrol; 1986 Jul; 26(1):1-6. PubMed ID: 3524925.
    Abstract:
    The purpose of the present longitudinal investigation was to assess the predictive value of urinary protein analysis in the early detection of rejection crisis after renal transplantation. Forty-one children were studied consecutively over a period of 6 months applying the following methods: creatinine clearance (Ccr); urinary total protein (UTP); and electrophoretic differentiation of urinary proteins according to their molecular size by microgradient-gel electrophoresis (MGGE) with a continuous concentration gradient of 4-40% of polyacrylamide. Protein fractions analyzed were albumin (69,000 d), low molecular weight proteins (LMW-proteins, less than 69,000 d), and high molecular weight proteins (HMW-proteins, greater than 69,000 d). No rejection was observed in 30 children (group A), a total of 18 rejection episodes occurred in 11 children (group B). UTP was significantly lower in group A as compared to group B (107 vs 376 mg/m2/24 h), but no differences in urinary protein pattern were observed between group A and group B prior to rejection. One to two days after rejection UTP increased to 938 mg/m2/24 h, and 3-7 days after rejection LMW-protein fraction increased from 9% to 23% with a corresponding decrease of albumin fraction from 71% to 56% of UTP. No qualitative changes were noted in respect to HMW-protein excretion. It is concluded that changes of UTP and urinary protein pattern occur during rejection episodes but are of no predictive value in detecting rejection before clinical symptoms appear.
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