What to do if proteinuria occurs after kidney transplantation

Kidney transplantation is a relatively common type of transplantation. If a kidney transplant can be performed when kidney failure occurs, it can save the patient's life. However, some rejection reactions may occur after the kidney transplant. At this time, the patient may experience proteinuria. Don't worry too much about this situation. Sometimes this is a normal rejection reaction. Of course, you must emphasize nutrition and make a timely diagnosis.

What to do if proteinuria occurs after kidney transplantation

1. The causes of proteinuria mainly include the following aspects:

Chronic rejection after kidney transplantation, especially chronic humoral rejection, recurrence of transplanted kidney disease, new onset glomerulitis of transplanted kidney, and renal damage caused by hepatitis. The causes of hematuria need to be differentiated into surgical hematuria and medical hematuria. The urine sediment of surgical hematuria shows homogeneous hematuria.

The urine sediment of medical hematuria is polymorphic hematuria. In surgical hematuria, it is important to rule out kidney, ureter, bladder tumors and inflammation. It is also necessary to rule out inflammation and tumors of the transplanted kidney and transplanted ureters, as well as problems with the prostate (in men) and urethra. If the hematuria is medical, it is necessary to consider whether it is a recurrence or new onset of nephritis.

2. How can we confirm the diagnosis?

The best way is to perform a transplanted kidney biopsy. A transplanted kidney biopsy and pathological examination can clarify the cause and guide the treatment plan.

If the transplanted kidney disease relapses, the most common is IgA nephropathy, followed by focal segmental sclerosis, membranous nephropathy, membranoproliferative nephritis, and some systemic diseases can also relapse, such as systemic lupus erythematosus, vasculitis, purpuric nephritis, anti-GBM nephritis, etc.

The clinical manifestations of relapse of these diseases are consistent with those of the original disease, but the clinical manifestations and pathological changes will be milder. This is because kidney transplant patients are taking immunosuppressants, which can inhibit the development of these diseases. Therefore, even if kidney disease recurs, the impact on the transplanted kidney will be relatively small. Kidney patients do not need to worry too much, unless some recurrent nephritis manifests as massive hematuria, proteinuria, and increased blood creatinine. These people often need to be hospitalized for active treatment to prevent the progression of the disease. Most recurrent nephritis can be controlled through treatment, and only a very small number of types of recurrent kidney disease are difficult to control.

Therefore, if a kidney transplant recipient develops proteinuria or hematuria after surgery, do not panic or worry too much. Instead, respond proactively, diagnose and adjust treatment in a timely manner, and most of the conditions can be well controlled. For some serious and complicated cases, it is necessary to go to a hospital with better conditions for a transplanted kidney biopsy in time, to make a clear diagnosis and receive timely treatment, so as not to miss the best time for treatment.