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What is chronic allograft nephropathy?

Dr Vijay Kher
Chairman,
Department of Nephrology and Kidney transplant Medicine,
Fortis Kidney and Urology Institute,
Fortis Escorts Hospital, New Delhi

Q: I am a kidney transplant patient for two years and had pulmonary tuberculosis a few months ago. I had nephrotic proteinuria and the graft biopsy said: chronic allograft nephropathy with focal segment of sclerosis. I am on prednisolone 10 mg, azoran 50 mg, INH 150 mg, ethambutol 400 mg, ofloxacin 400 mg, pyridoxine 10 mg, losartran 25 mg and enalapril 2.5 mg. My question is what is nephropathy? How can it be maintained at this situation? What will be my diet? What is the function of losartran and enalapril?

A:Nephropathy means involvement of kidney in a disease process. You have chronic allograft nephropathy which is a mixture of chronic rejection and other factors like drugs, high blood pressure, recurrent disease affecting the transplant kidney. It needs optimising immunosuppressive drugs & taking care of all other factors which affect kidney function. Losartan & enalapril decrease protein in urine and control blood pressure and are good for kidney. Your doctor should discuss your diet.