ABSTRACT
Fifty [50] renal transplant recipients were included in this study [30 males and 20 females]. The post transplant period ranged between 2 months and 84 months [mean36.86 +/- 23.92]. The source of renal graft was live related donor [12 patients], live unrelated donor [22] and cadaveric donor [16]. ten healthy volunteers were selected as a control group. The aim of this study is to look at the pattern of proteinuria in renal transplant recipients and to find a relation between the degree and type of this proteinuria and the renal allograft function, a matter which has a great importance for early detection of rejection. These 50 patients were divided into two groups group 1 30 patients with normal graft functions and group 2 20 patients with impaired graft functions. The results of this study showed that the mean value of 24th urinary proteins in both groups was 1.45 +/- 0.07 gm/dl. There was a highly significant difference between group 1 and group 2 regarding the renal functions [blood urea, serum creatinine and creatinine clearance], quantitative 24h. urinary proteins and the pattern of urinary protein electro-phoresis [P < 0.001]. Twelve patients [24%] were found to have signs of chronic rejection Hypertension, oliguria, impaired renal functions leucocyturia, proteinuria and hematuria], where urinary protein electrophoresis showed albumin, IgG, alpha microglobulin and transferrin in a significantly high concentration when these were compared with other renal transplant patients without signs of rejection. It was also found that 14 patinets [28%] had evidence of cytomegalovirus infection [seropositive CMV IgM], all of them had impaired renal graft functions with 24h. Urinary protein excretion which showed a highly significant difference when compared with patients who had seronegative CMV-IgM, with predominant beta 2 [B2] microglobulin excretion [P < 0.001]. urinary tract infection was reported in 7 patients [14%], 4 of them had impaired renal functions with significant proteinuria, predominantly albumin and B2 microglolmllin. Also cyclosporin nephrotoxicity was noticed in 3 patients [6%], the pattern of proteinuria among them showed albumin and IgG in high concentrations