Etiology of Renal Allograft Dysfunction: A Single Center-based Study

Abstract

Background: Multiple factors interplay in development of acute or chronic renal allograft dysfunction. Biopsy is the gold standard modality of evaluating the cause of transplant dysfunction. Objective: The present study was aimed to assess the etiology behind allograft dysfunction. Methods: A longitudinal, observational approach was carried forward to investigate 79 renal transplant recipients during the period of September 2022 to March 2025 in Center for Kidney Diseases & Urology Hospital in Dhaka, Bangladesh. Results: Findings revealed, mean age of the participants was 35.03 ± 9.351 years; 78.5% were males, mean serum creatinine level was 262.4 ± 143.04 µmol/L and mean duration between transplant and diagnosis of allograft dysfunction was 1.60 ± 2.783 years. In addition, the native kidney disease of 84.5 % of the study population was not identified prior to transplantation. Active antibody-mediated rejection (ABMR), calcineurin inhibitor (CNI) toxicity and acute tubular injury were the prevalent etiologies revealed in this study (16.5%, 13.5% and 10.1%) respectively. The highest mean serum creatinine level (384.0 ± 118.7 µmol/L) was detected for combination etiology of acute T-cell mediated rejection (TCMR) and active ABMR. The longest duration between transplant and diagnosis (4.50 ± 4.44 years) was found in case of chronic active ABMR. Conclusion: Early detection and prompt evaluation are crucial for the management of this grievous condition and the prevention of long-term complications.