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Nephrol Dial Transplant (2002) 17: 4-8
© 2002 European Renal Association-European Dialysis and Transplant Association

IV.2.1 Differential diagnosis of chronic graft dysfunction

Guidelines

A. Any significant deterioration in graft function should be investigated using the appropriate diagnostic tools and, if possible, therapeutic interventions should be initiated. The usual causes of a decline in glomerular filtration rate after the first year include transplant-specific causes such as chronic allograft nephropathy, acute rejection episodes, chronic calcineurin inhibitor nephrotoxicity, transplant renal artery stenosis and ureteric obstruction, as well as immunodeficiency-related causes and non-transplant-related causes, such as recurrent or de novo renal diseases and bacterial infections.

(Evidence level B)

B. Any new onset and persistent proteinuria of >0.5 g/24 h should be investigated and therapeutic interventions should be initiated. The usual causes include chronic allograft nephropathy and transplant glomerulopathy, and recurrent or de novo glomerulonephritis.

(Evidence level B)


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