The Analysis Of Treatment On Borderline Changes Of Renal Grafts

Aim: To investigate appropriate treatment after observing the borderline changes of renal grafts.Method: 25 patients were involved in this research from April 2006 to April 2009 in our hospital, which confirmed the borderline changes by renal grafts biopsy due to increased serum creatinine. These patients were divided into two groups accroding to the different treatment. The first group (control group), a total of 15 cases were treated with methylprednisolone shock therapy; the second group (study group), a total of 10 cases were treated with oral prednisone acetate tablets shock therapy. The clinical follow-up data of two groups will be analyzed retrospectively.Result: The clinical follow-up data of two groups were obtained within 1 year after treatment, and compared each other.①Application of methylpredni- solone shock therapy in renal transplant patients (control group), the level of renal creatinine before treatment were (152.47±22.18)μmol/L; the level of renal creatinine 3 months, 6 months and 1 year after treatment were (124.73±22.29) μmol/L, (118.73±23.46)μmol/L and (120.93±15.16)μmol/L, respectively. 9 patients occurred hypokalemia during treatment, the incidence was 60% (9/15); 10 patients occurred acidosis, the incidence was 66.7% (10/15); 15 patients occurred high blood glucose, the incidence was 100% (15/15).②Application of oral prednisone therapy in renal transplant patients (study group), the level of renal creatinine before treatment were (141.50±19.98)μmol/L, the level of renal creatinine 3 months, 6 months and 1 year after treatment were (121.10±13.39)μmol/L, (117.20±9.40)μmol/L and (116.10±13.20)μmol/L. 1 paitient occurred hypokalemia, the incidence was 10% (1/10); 1 paitient occurred acidosis, the incidence was 10% (1/10); 2 patients occurred high blood glucose, the incidence was 20% (2/10). We analyzed the data of these two groups: the serum creatinine levels of the paitients which confirmed the borderline changes by renal grafts biopsy were significantly lower at the time points of 3 months, 6 months and 1 year after treatment than before in both two groups (p<0.05 ); there were no significant difference of serum creatinine levels within the same group before or after treatment (p>0.05); In study group, the incidence of hypokalemia, acidosis and high blood sugar were 60%, 66.7% and 100%, respectively; in study group, the incidence of hypokalemia, acidosis and high blood sugar were 10%, 10% and 20%, respectively. The difference was significant compared the incidence between two groups (p<0.05).Conclusion: (1) The level of serum creatinine of the patients which have the borderline changes of renal grafts after methylprednisolone therapy or oral prednisolone therapy decreased significantly in both groups, both two kinds of therapy are effective. (2) There were no significant difference of the effect of both therapies in one year after treatment. (3) The paitients with the borderline changes have the lower incidence of hypokalemia, acidosis and high blood sugar in oral prednisolone group, the difference was significant compared with methylprednisolone group. (4) The methylprednisolone therapy is an effective and more safety therapy.