To evaluate AT1R expression in kidney allograft biopsies and the presence of anti-AT1R antibodies in kidney transplant recipients, and to assess their association with chronic allograft dysfunction.
Approach:
Study Design: A longitudinal study involving 77 kidney transplant recipients who underwent indication biopsies within 60 months post-transplantation.
Assessment Methods: AT1R expression was assessed by immunohistochemistry, and serum anti-AT1R antibody levels were measured using ELISA.
Follow-Up: Histopathological findings and long-term graft outcomes were evaluated over a median follow-up of 126 months.
Key Findings:
AT1R expression in tubular epithelium was observed in 44.2% of patients.
Transplant glomerulopathy (TG) and interstitial fibrosis (IF) were significantly more frequent in patients with positive AT1R expression (24% vs. 7%, p=0.042; 56% vs. 27%, p=0.011).
IF severity was higher in the AT1R-positive group (p=0.028).
Anti-AT1R antibody levels did not differ between groups.
The presence of multiple risk factors, including AT1R expression and histopathological lesions, was associated with worse long-term graft survival.
Interpretation:
AT1R expression is associated with the presence and severity of interstitial fibrosis and transplant glomerulopathy in kidney transplant recipients.
Limitations:
The study had a loss of 22 patients during follow-up.
The analysis was limited to a specific cohort of kidney transplant recipients.
Conclusion:
These findings suggest a role of AT1R-mediated pathways in chronic allograft injury.
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