Since many reports support the utility of urine cytology and BK virus DNA PCR as a screening strategy for BKVN,[29] protocol biopsies only for BKVN may be unnecessary. Chronic rejection involves clinical and subclinical damage to the allograft, caused by cell-mediated and/or antibody-mediated immune

mechanisms. In addition to this chronic immune damage to the allograft, a variety of non-immunological factors reduce nephron mass, including advanced donor age, ischaemic injury to the graft during implantation, hypertension, diabetes, chronic CNI nephrotoxicity and infection. Immune and non-immune mechanisms act in parallel. Ultimately, these LGK-974 molecular weight processes cause interstitial fibrosis and tubular atrophy. As interstitial fibrosis and tubular atrophy caused by chronic rejection, chronic CNI toxicity,

chronic ischaemic injury or chronic infection sometimes cannot be distinguished in biopsy specimens, we should recognize that interstitial fibrosis and tubular atrophy have a multifactorial nature of chronic renal injury. Some pathologists believe that use of the term ‘IF/TA’ as a histological descriptor should be restricted as much as possible because it generates uncertainty rather than precision. Although protocol biopsies performed during the early post-transplantation period INK 128 ic50 may facilitate prediction of graft survival, the procurement of long-term protocol biopsies for the sole purpose of detecting

subclinical rejection may be unwarranted. In contrast, the early detection of IgA nephropathy using long-term protocol biopsy may improve graft survival. Also, the presence of normal histology on a protocol biopsy may inform us about the safety of reducing overall immunosuppression. Thus, Obatoclax Mesylate (GX15-070) potential benefits of long-term protocol biopsy may be of clinical significance for the detection of graft dysfunction as a result of non-immune factors, such as recurrence of glomerulonephritis and CNI nephrotoxicity, rather than subclinical rejection. Multicentre randomized trials in kidney transplantation should be designed and implemented to evaluate the value of long-term protocol biopsies. “
“Diabetic nephropathy (DN), a common microvascular complication of type 2 diabetes mellitus (T2DM) is polygenic, with a vast array of genes contributing to disease susceptibility. Accordingly, we explored the association between DN and six polymorphisms in oxidative stress related genes, namely eNOS, p22phox subunit of NAD(P)H oxidase, PARP-1 and XRCC1 in South Indian T2DM subjects. The study included 155 T2DM subjects with DN and 162 T2DM patients with no evidence of DN. The selected polymorphisms were genotyped by polymerase chain reaction and Taqman allele discrimination assay.