[Factors influencing the development of chronic renal allograft nephropathy in children].

Chronic renal graft nephropathy (CRGN), with progressive deterioration of graft function and development of chronic graft pathology remains the main cause of late graft loss. Overall 191 patients, at aged 1.5 to 19 years were evaluated, divided in two groups: #1 (n = 103) with pathomorphological CRGN pattern in renal biopsy, and #2 (n = 88) with no chronic changes (22) or no indication to biopsy (66). Several factors were evaluated, including HLA matching, PRA, early graft function, early and late acute rejection, hypertension index, proteinuria, hemoglobin and albumin level, CsA dosing, blood levels and instability, CMV infection, CMV in-situ presence in the graft and correlations with graft survival and time post-transplant when CRGN assessed with Banff and CADI scales, occurred in renal biopsy, were analyzed. Statistical analysis showed, that significantly lower CsA blood level and dosage at 1,2,3 years post-transplant, CsA blood level instability, acute rejection within first year post-transplant, poor control of hypertension, proteinuria, lower hemoglobin level and hypoalbuminemia were major, while delayed graft function, CMV infection and CMV in-situ presence in renal tissue were minor factors affecting development of CRGN.