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Kidney transplant offers a significant improvement in life expectancy and quality of life for people with End Stage Renal Disease (ESRD). Unfortunately, Chronic Allograft Nephropathy (CAN) remains a daunting problem. More than 20% of kidney transplants performed in the USA go to patients who have failed one or more renal allografts. Then, how is CAN diagnosed?
CAN is the leading cause of late allograft loss in kidney transplant. In clinic, chronic allograft nephropathy is characterized by a slow but variable loss of function, beginning three months after implantation, usually combined with proteinuria generally in the non-nephrotic range and high blood pressure.
As for the diagnosis of CAN, the first indication is often progressive decline of kidney function measured by elevated serum creatinine levles or the appearance of overt protein in the urine. However, evaluation of large number of registry data has shown that serum creatinine level has limited predictive value for further graft loss.
Actually, a simplex reference range for creatinine level can be misleading and usually underestimates the decline of renal function, especially at glomerular filtration rate (GFR) between 30 and 70mL/min. A considerable amount of damage may already have been done when the patient starts showing increasing serum creatinine levels. By then, it may be too late for successful intervention.
Study shows that CAN at 2 years was associated with older donor age, early acute rejection, and episodes of acute CNI nephrotoxicity. One study found that 94% of grafts has histological evidence of interstitial fibrosis and tubular atrophy at one year.
Kidney transplant is not a cure, but an alternative to dialysis. Transplantation does involve risk, it may fail and there are side effects. If a transplant fails, patients can go back to dialysis or possibly have another transplant.
If you or your beloved one is suffering from CAN or failed kidney transplant, we are here to help provide better solution. You can leave a message in the below or Email to firstname.lastname@example.org .