A disproportionately greater body weight of the recipient in regards to the donor causes chronic graft nephropathy. A study of paired kidneys.

BACKGROUND Chronic graft nephropathy is the most frequent cause of long-term renal transplant loss. Although immunological causes participate in its pathogenesis, other non-immunological factors such as hyperfiltration due to reduced renal mass have been proposed as causal factors of chronic renal graft nephropathy. AIM This study aimed to assess the effect of weight disproportion between the donor and recipient in the development of chronic renal graft nephropathy. METHODS Three weight categories for donors and recipients were established: < 50, 50-75 and > 75 kg. Three groups were distinguished according to the three possible weight combinations between donor and recipient: donor weight (DW)>recipient weight (RW) (N = 133), DW = RW (N = 255) and DWRW groups. In addition, the DW<RW group developed higher proteinuria even by 3 months of evolution. Donor and recipient age, acute rejection and type of immunosuppressive treatment were also independent risk factors to develop chronic nephropathy in this study of paired kidneys. CONCLUSIONS Weight disproportion between donor and recipient, unfavourable to the recipient, is a risk factor for the development of chronic graft nephropathy. Matching the body weights between the donor and recipient is obligatory to prevent chronic rejection.