Study of the Spectrum of Pathological Findings in Renal Transplant Recipients with an Asymptomatic Slow Rise in Serum Creatinine at a Tertiary Care Centre in North India
Niranjan Gogoi *
Department of Nephrology, SMS Medical College, Jaipur, Rajasthan, India.
Megha Agarwal
Department of Nephrology, Mahatma Gandhi College Jaipur, Rajasthan, India.
Arjun Agarwal
Department of Nephrology, SMS Medical College, Jaipur, Rajasthan, India.
Rakesh Gupta
Department of Nephrology, SMS Medical College, Jaipur, Rajasthan, India.
Dhananjai Agarwal
Department of Nephrology, SMS Medical College, Jaipur, Rajasthan, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Chronic allograft dysfunction, characterized by a progressive increase in serum creatinine levels after kidney transplantation, poses a significant challenge in renal transplant recipients.
Aim: This study aimed to assess the spectrum of pathological findings in renal transplant recipients with an asymptomatic slow rise in serum creatinine.
Methodology: A hospital-based cross-sectional study was conducted, including patients who underwent kidney transplantation and exhibited a creeping rise in creatinine within 3 months to one year. Renal biopsies were performed, and the samples were analysed using various techniques.
Results: Among 30 patients included in the study, a high prevalence of acute tubular necrosis20%(n=6), active antibody-mediated rejection20%(n=6),chronic active antibody-mediated rejection20%(n=6), chronic allograft injury10%(n=3), chronic T cell-mediated rejection10%(n=3), acute cellular rejection10%(n=3), membranous nephropathy(n=1), C3 glomerulonephritis(n=1), and cortical necrosis(n=1) was observed. The timing of biopsy post-transplantation and donor HLA mismatch were also evaluated.
Conclusion: These findings emphasize the importance of early detection and proper management of pathological conditions contributing to chronic allograft dysfunction to improve long-term outcomes following kidney transplantation.
Keywords: Chronic allograft dysfunction, renal transplant, serum creatinine, graft failure