Thus, patients whose graft or patient survival was more than 4?years were only assessed until the fourth 12 months after transplantation. Definitions The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease (MDRD) equation: eGFR (mL/min/1.73?m2) = exp (5.228C1.154 Chloroprocaine HCl ln (SCr) ? 0.203 ln (age) ? (0.299 if female) + (0.192 if black). HCV patients showed more acute rejection, a higher degree of Chloroprocaine HCl proteinuria accompanied by a diminution of renal function, more graft biopsies and lesions of glomerulonephritis and transplant glomerulopathy. Serum creatinine and proteinuria at 1 year, acute rejection, HCV positivity and systolic blood pressure were impartial risk factors for graft loss. Patient survival was 96.3% in the whole group, showing a significant difference between HCV-negative HCV-positive patients (96.6% 94.5%, 0.05). Serum creatinine and diastolic blood pressure at 1 year, HCV positivity and recipient age were impartial risk factors for patient death. Conclusions. Renal transplantation is an effective therapy for HCV-positive patients with good survival but substandard than results obtained in HCV-negative patients in the short term. Notably, HCV-associated renal damage appears early with proteinuria, elevated serum creatinine showing chronic allograft nephropathy, transplant glomerulopathy and, less frequently, HCV-associated glomerulonephritis. We suggest that HCV contamination should be recognized as a true risk factor for graft failure, and preventive steps could include pre-transplant therapy with interferon. 1998C2002. Materials and methods Sources of data The data on recipients were collected from individual transplant centres participating in the Spanish Chronic Allograft Nephropathy Study Group, which comprised 34 out of 38 adult kidney LIMK2 transplant centres in Spain and 96% of all adult kidney transplant recipients in Spain who were alive with a functioning graft at 1?12 months post-transplant, during the studied years (1990, 1994, 1998 and 2002). Study population According to the Spanish National Transplant Business (ONT), total cases of transplanted patients in the years 1990, 1994, 1998 and 2002 were 6901 (source: www.ont.msc.es), of which 5060 (73.3% of total) transplants were included by the 34 centres participating in the study. The inclusion criteria were to be recipients of a single organ with a functioning graft at 1 year post-transplant and more than 2?years of follow-up. We found 89 (1.8%) patients younger than 18?years. Furthermore, 91 (1.8%) cases were excluded for having an inferior graft survival at 1?12 months. Eighty-six (1.7%) patients were not included because no data were available for monitoring, and therefore, the total quantity of patients analysed was 4842 (95.7%). Distribution of patients according to the serology for hepatitis C and B computer virus was the following: 97.5% of patients (= 4304) did not have hepatitis B virus, of which 13.6% (= 587) presented HCV+ and the remaining 86.4% (= 3717) HCV?. Methods For the following analysis, we have taken into account all evaluable patients not showing HBV+ (= 4304), disaggregated by the year of transplantation: 1990C94 (= 1659, 38.5%) = 2645, 61.5%). To avoid the need to change survival per year of transplant, given that monitoring of patients is significantly higher in those transplanted between 1990 and 1994 than in those transplanted between 1998 and 2002 (and as its follow-up varies from 16C12?years to 8C4?years, respectively), graft and patient survival were examined during the first 4 years after transplantation. Thus, patients whose graft or patient survival was more than 4?years were only assessed until Chloroprocaine HCl the fourth 12 months after transplantation. Definitions The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease (MDRD) equation: eGFR (mL/min/1.73?m2) = exp (5.228C1.154 ln (SCr) ? 0.203 ln (age) ? (0.299 if female) + (0.192 if black). Induction was considered whether the immunosuppressive was ALG/ATG or OKT3 or anti-IL-2R. HCV contamination was defined by the presence of HCV antibody (ELISA2/3). Statistical analysis Statistical treatment of data was done with the support of SPSS version 17.0. Continuous variables were explained using steps of central tendency (mean, median) and measure of dispersion (standard deviation, minimum and maximum). Categorical variables were described as complete and relative frequency. The survival function was evaluated by KaplanCMeier, Cox regression and log-rank test, to study graft and individual survival, as well as the association between graft and individual survival and the presence of HCV+ or the cohort (transplanted in 1990C94 or 1998C2002). Results Donor and recipient characteristics Mean donor age was 42.39 16.9 (range 12C86) years that was significantly higher in HCV-negative 42.77 16.9 than HCV-positive patients 39.98 16.31?years ( 0.001). Donor age significantly increased in the period 1998C2002, 45.35 16.81 37.56 15.9 in 1990C94 ( 0.001) in all patients and separated in HCV+ and HCV? patients. Mean recipient age was 46.6 13.27 (range 18C78) years; this also was significantly higher in HCV-negative 46.8 13.3?years than HCV-positive patients 45.2 12.8?years ( 0.005). Recipient age increased significantly in the period 1998C2002, 48.21 13.4 44.1 12.6?years in 1990C94 ( 0.001) in all patients and separately in HCV+ and HCV? patients. Gender was 62.2% males and.