Atypical Hemolytic Uremic Syndrome: New Challenges in the Complement Blockage Era.

Atypical hemolytic uremic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA), characterized by microangiopathic hemolytic anemia, consumptive thrombocytopenia, and multisystem end organ involvement, most commonly affecting the kidney. Diagnosis is clinical, after exclusion of other TMA causes. Primary aHUS arises from genetic abnormalities, resulting in uncontrolled complement activity, while a variety of clinical scenarios cause secondary aHUS, including infection, pregnancy, malignancy, autoimmune disease, and medications.

Prognostic Significance of Creeping Proteinuria in the First Year After Transplantation.

Background: Proteinuria changes have a prognostic significance in proteinuric nephropathies. Proteinuria has been related to kidney transplant outcomes, but there are no information about the impact of increasing proteinuria during the first year on long-term graft and patient survival.

Methods: Retrospective cohort study of 591 kidney transplants to analyze the effect on long-term prognosis of: proteinuria at 3 (n = 591) and 12 (n = 583) months (no proteinuria: 150-299 mg/24 hours, 300-999 mg/24 hours, and ≥1 g/24 hours), and changes in proteinuria during the first year in such patients with proteinuria at 3 months (reduction ≥50% of proteinuria from 3 to 12 months, variation <50%, and increase ≥50% or "creeping proteinuria") (n = 283).