Temporal changes of proteinuria after kidney transplantation: association with cardiovascular morbidity and mortality
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ORIGINAL ARTICLE
Temporal changes of proteinuria after kidney transplantation: association with cardiovascular morbidity and mortality Maya Molcho1 · Benaya Rozen‑Zvi1,2 · Tali Shteinmats1,2 · Naomi Ben Dor1,2 · Itay Vahav1 · Eviatar Nesher1,3 · Ruth Rahamimov1,2,3 Received: 25 October 2019 / Accepted: 6 January 2020 © Italian Society of Nephrology 2020
Abstract Background Proteinuria is common in kidney transplant recipients and has been established as a risk factor for graft-loss and mortality. In the general population, proteinuria has also been tied to a higher risk of cardiovascular disease. There is limited data exploring the association between changes in proteinuria over time and cardiovascular disease in kidney transplant recipients. Methods In this retrospective cohort study we evaluated proteinuria as a time-varying covariate using urine dipstick protein values at 6 month intervals post-transplant. The primary outcome was the occurrence a major cardiovascular event (MACE). Univariate and multivariate time varying Cox model was used. Results 579 patients were included in the final cohort. 120 episodes of MACE were documented in 98 patients. Time varying proteinuria was associated with MACE by univariate and multivariate analysis (HR 2.63, 95% CI 1.76–3.93, p
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