الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The transplanted kidney is faced with a considerable number of stresses and injuries caused by toxic conditions (such as calcineurin inhibitors), surgical pressure, or immunologic insults. These stresses compromise tissue viability and lead to interstitial fibrosis/tubular atrophy, progressive graft dysfunction, and graft loss.
The aim of this study was to study the correlation of serum levels of Autophagy protein 5 (Atg5), malondialdehyde and total antioxidant capacity with renal allograft function and survival in a sample of Egyptian patients with renal transplant.
In order to achieve this goal, 45 subjects were divided into three groups; group I consisted of 15 patients with renal transplantation and stable renal function (serum creatinine < 2 mg/ dl), group II consisted of 15 patients with renal transplantation and chronic allograft dysfunction (CAD) (serum creatinine > 2 mg/dl) and group III consisted of 15 healthy subjects representing the controls. The study involved patients transplanted for more than six months.
All groups were evaluated as regards complete history taking: including history of previous renal diseases, previous renal transplantation, previous attacks of acute rejection or infection and the type of immunosuppressive drugs and complete clinical evaluation.
The following investigations were performed for all patients and healthy subjects:
• Routine laboratory tests, including CBC and renal function tests.
• Complete urine analysis with measurement the urinary protein excretion rate (urinary protein/urinary creatinine ratio).
• Serum C- reactive protein: using ELISA kit.
• Therapeutic drug monitoring for all transplanted patients (TDM).
• Serum Atg5 level: using ELISA kit.
• Serum levels of oxidative stress markers; malondialdehyade and total antioxidant capacity (TAC) using colorimetry.
Statistical analysis of the studied parameters showed the following results:
• Serum level of Atg5 was significantly higher in group II than in groups I and controls. (p =0.002)
• MDA level was significantly higher in group II than group I and controls. (p< 0.001)
• TAC level showed significant difference between the three groups. (p=0.006)
• Atg5 level was positively correlated with S.Cr, HsCRP, cyclosporine trough level, and MDA level, and was negatively correlated with e-GFR and TAC level in group I and II.
• Serum level of MDA was positively correlated with serum creatinine, HsCRP in group I and II and with cyclosporine trough level in group II, and was negatively correlated with e-GFR level in both groups.
• Serum level of TAC was positively correlated with e-GFR level in both groups, and was negatively correlated with serum creatinine, HsCRP and MDA in both groups, and with cyclosporine trough level in group I.
• Renal fibrosis was positively correlated with serum creatinine, HsCRP, cyclosporine trough level, MDA, and Atg5 level, and was negatively correlated with e-GFR level in group II.
• The present study has concluded that ATG5 and MDA are potential markers to predict future deterioration of renal allograft, where their increase in the serum of renal transplant patients, represent an alaming sign.