Proteinuria and Nephrotic Syndrome Associated with Chronic Rejection of Kidney Transplants

THE continuing function of transplanted kidneys depends on the development of a degree of "tolerance" between graft and recipient and the judicious use of immunosuppressive therapy to further this adaptation without disrupting the defense against infection. When major incompatibility exists, there is often an acute systemic response – the acute rejection "crisis" that in most instances responds to massive steroid therapy. Improved immunosuppressive therapy and, more recently, methods of matching graft and recipient have decreased the threat of acute rejection while increasing the incidence of a more subtle expression of incompatibility – the chronic rejection syndrome. Attention has therefore focused . . .