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Differential Diagnosis of Chronic Allograft Nephropathy (CAN)


2012-10-01 15:30

Despite improved changes of immunosuppressive regimens, progressive transplant loss attributable to Chronic Allograft Nephropathy (CAN) continues presenting. CAN is the leading cause for progressive renal failure and graft loss. Here, we'd like to talk about the differential diagnosis of the disease.

Differential Diagnosis of Chronic Allograft Nephropathy

CAN is a histopathological diagnosis used to denote features of chronic interstitial fibrosis and tubular atrophy within the renal allograft. The diagnosis of this disease should be distinguished with other illnesses.

The histological features that define CAN in the kidney transplant allograft are interstitial fibrosis, tubular atrophy, glomerulosclerosis and fibrointimal hyperplasia. Based on the severity of chronic interstitial fibrosis and tubular atrophy and the area of cortex affected in the biopsy specimen, CAN is graded as mild, moderate or severe.

In addition, understanding the clinical manifestations of CAN is also beneficial to make a differential diagnosis of the disease. In general, the manifestations are occult, often no obvious symptoms. They often occur in 3 to 6 months after the surgery.

Approximately 80% of people with the disease got the symptoms of slow loss of transplanted kidney function and the increase of serum creatinine levels. About 28 percent of patients may also experience proteinuria with varied degrees and some patients may also present elevated blood pressure. However, these are not the specific manifestations.

From the histology of the transplanted kidney, we can still detect the pathological changes of CAN, and this condition is called "chronic allograft subclinical kidney disease". This needs the routine biopsy of the transplant kidney. In this way, we can detect the disorder early and treat it timely.

Is there still any questions about Chronic Allograft Nephropathy? You can leave a message or send an Email to kidneyabc@hotmail.com . We are glad to help you!




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