Do serum C-reactive protein measurements help to discriminate episodes of renal dysfunction in patients after renal transplantation?

Citation
C. Reek et al., Do serum C-reactive protein measurements help to discriminate episodes of renal dysfunction in patients after renal transplantation?, CLIN CHIM A, 310(1), 2001, pp. 57-61
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
CLINICA CHIMICA ACTA
ISSN journal
0009-8981 → ACNP
Volume
310
Issue
1
Year of publication
2001
Pages
57 - 61
Database
ISI
SICI code
0009-8981(20010801)310:1<57:DSCPMH>2.0.ZU;2-M
Abstract
Introduction: This study investigated whether serial daily measurements of serum C-reactive protein (sCRP) could help differentiate episodes of transp lant dysfunction due to rejection, infection, cyclosporine A (CsA) nephroto xicity, or acute tubular necrosis (ATN) in renal-allograft recipients. Mate rials and Methods: Morning serum was obtained daily from 134 patients durin g the first 30 days after renal transplantation. All episodes of graft dysf unction were recorded and differentiated with transplant biopsies. CRP conc entrations were correlated with post-operative graft function and the vario us causes of graft dysfunction. Results: All patients showed an increase in sCRP in response to surgery, with a maximum on day 2 after transplantation . The sCRP concentration was significantly higher in patients with delayed graft function (mean 61.50 mug/ml) than in patients with primary graft func tion (mean 38.01 mug/ml) (p=0.001). Bacterial infections other than asympto matic bacteriuria (mean sCRP 33.98 mug/ml), interstitial graft rejection (m ean sCRP 16.43 mug/ml), and ATN (mean sCRP 30.50 mug/ml) were accompanied b y significant increases in sCRP compared with uneventful courses. sCRP was unchanged in the presence of viral infections or CsA toxicity. Conclusion: Serial sCRP measurements help to identify renal-transplant dysfunction of d ifferent origins. However, rejection, infection and ATN show similar patter ns of sCRP increase. Thus, sCRP is unable to discriminate the causes of ren al-graft dysfunction. Biopsy remains the gold standard for the differential diagnosis of renal-allograft dysfunction. (C) 2001 Elsevier Science BN. Al l rights reserved.