Treatment of proteinuria with low-molecular-weight heparin after renal transplantation

The development of nephrotic-range proteinuria after renal transplantation is an unfavourable prognostic factor for graft survival. In contrast to that in other nephropathies, the role of renin-angiotensin blockade in kidney transplantation is less well defined, and its anti-proteinuric effect is ma...

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Bibliographic Details
Published in:Transplant international 2004-09, Vol.17 (8), p.468-472
Main Authors: KRZOSSOK, Stefan, BIRCK, Rainer, KOEPPEL, Hannes, SCHNÜLLE, Peter, WALDHERR, Rüdiger, VAN DER WOUDE, Fokko J, BRAUN, Claude
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
Biological and medical sciences
General aspects
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Kidney Transplantation - adverse effects
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Pharmacology. Drug treatments
Postoperative Complications - drug therapy
Proteinuria - drug therapy
Time Factors
Treatment Outcome
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Citations: Items that this one cites
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Summary:The development of nephrotic-range proteinuria after renal transplantation is an unfavourable prognostic factor for graft survival. In contrast to that in other nephropathies, the role of renin-angiotensin blockade in kidney transplantation is less well defined, and its anti-proteinuric effect is markedly reduced in the presence of segmental glomerulosclerosis. Here, we describe two patients who developed severe proteinuria after renal transplantation, despite effective blood pressure control with an ACE inhibitor. Histological changes were consistent with IgA-nephropathy and focal segmental glomerulosclerosis. Both patients were treated with low-molecular-weight heparin in addition to pre-existing ACE inhibition. This regimen led to a significant and long-lasting reduction of proteinuria. Our data suggest that low-molecular-weight heparin possesses strong renoprotective properties, thus confirming previous data from experimental nephropathies. This approach might represent a promising new strategy for treatment of proteinuria after kidney transplantation.
ISSN:0934-0874
1432-2277
DOI:10.1007/s00147-004-0743-2