BACKGROUND AND OBJECTIVES: Current tools to predict outcomes after kidney transplantation are inadequate. The objective of this study was to determine the association of perioperative urine neutrophil gelatinase-associated lipocalin and IL-18 with poor 1-year allograft function (return to dialysis or estimated GFR<30 ml/min per 1.73 m(2)). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Neutrophil gelatinase-associated lipocalin and IL-18 from early post-transplant urine was measured in this prospective, multicenter study of deceased-donor kidney transplant recipients. The outcome of poor allograft function at 1 year relative to these biomarkers using multivariable logistic regression and net reclassification improvement was examined. Also, the interaction between delayed graft function and the biomarkers on the outcome were evaluated, and the change in biomarkers over consecutive days related to the outcome using trend tests was examined. RESULTS: Mean age for the 153 recipients was 54 ± 13 years. Delayed graft function occurred in 42%, and 24 (16%) recipients had the 1-year outcome. Upper median values for neutrophil gelatinase-associated lipocalin and IL-18 on the first postoperative day had adjusted odds ratios (95% confidence interval) of 6.0 (1.5-24.0) and 5.5 (1.4-21.5), respectively. Net reclassification improvement (95% confidence interval) was significant for neutrophil gelatinase-associated lipocalin and IL-18 at 36% (1%-71%) and 45% (8%-83%), respectively. There was no significant interaction between biomarkers and delayed graft function on the outcome. Change in biomarkers moderately trended with the outcome. CONCLUSIONS: Perioperative urine neutrophil gelatinase-associated lipocalin and IL-18 are associated with poor 1-year allograft function, suggesting their potential for identifying patients for therapies that minimize the risk of additional injury.
BACKGROUND AND OBJECTIVES: Current tools to predict outcomes after kidney transplantation are inadequate. The objective of this study was to determine the association of perioperative urine neutrophil gelatinase-associated lipocalin and IL-18 with poor 1-year allograft function (return to dialysis or estimated GFR<30 ml/min per 1.73 m(2)). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Neutrophil gelatinase-associated lipocalin and IL-18 from early post-transplant urine was measured in this prospective, multicenter study of deceased-donor kidney transplant recipients. The outcome of poor allograft function at 1 year relative to these biomarkers using multivariable logistic regression and net reclassification improvement was examined. Also, the interaction between delayed graft function and the biomarkers on the outcome were evaluated, and the change in biomarkers over consecutive days related to the outcome using trend tests was examined. RESULTS: Mean age for the 153 recipients was 54 ± 13 years. Delayed graft function occurred in 42%, and 24 (16%) recipients had the 1-year outcome. Upper median values for neutrophil gelatinase-associated lipocalin and IL-18 on the first postoperative day had adjusted odds ratios (95% confidence interval) of 6.0 (1.5-24.0) and 5.5 (1.4-21.5), respectively. Net reclassification improvement (95% confidence interval) was significant for neutrophil gelatinase-associated lipocalin and IL-18 at 36% (1%-71%) and 45% (8%-83%), respectively. There was no significant interaction between biomarkers and delayed graft function on the outcome. Change in biomarkers moderately trended with the outcome. CONCLUSIONS: Perioperative urine neutrophil gelatinase-associated lipocalin and IL-18 are associated with poor 1-year allograft function, suggesting their potential for identifying patients for therapies that minimize the risk of additional injury.
Authors: Olwyn Johnston; Patrick O'kelly; Susan Spencer; John Donohoe; J Joseph Walshe; Dilly M Little; David Hickey; Peter J Conlon Journal: Nephrol Dial Transplant Date: 2006-05-23 Impact factor: 5.992
Authors: Margaret S Pepe; Ziding Feng; Ying Huang; Gary Longton; Ross Prentice; Ian M Thompson; Yingye Zheng Journal: Am J Epidemiol Date: 2007-11-02 Impact factor: 4.897
Authors: D Anglicheau; A Loupy; C Lefaucheur; F Pessione; I Létourneau; I Côté; K Gaha; L-H Noël; N Patey; D Droz; F Martinez; J Zuber; D Glotz; E Thervet; C Legendre Journal: Am J Transplant Date: 2008-09-10 Impact factor: 8.086
Authors: Andrew S Levey; Josef Coresh; Tom Greene; Lesley A Stevens; Yaping Lucy Zhang; Stephen Hendriksen; John W Kusek; Frederick Van Lente Journal: Ann Intern Med Date: 2006-08-15 Impact factor: 25.391
Authors: Sri G Yarlagadda; Steven G Coca; Richard N Formica; Emilio D Poggio; Chirag R Parikh Journal: Nephrol Dial Transplant Date: 2008-12-22 Impact factor: 5.992
Authors: Steven G Coca; Amit X Garg; Heather Thiessen-Philbrook; Jay L Koyner; Uptal D Patel; Harlan M Krumholz; Michael G Shlipak; Chirag R Parikh Journal: J Am Soc Nephrol Date: 2013-12-19 Impact factor: 10.121
Authors: Peter P Reese; Isaac E Hall; Francis L Weng; Bernd Schröppel; Mona D Doshi; Rick D Hasz; Heather Thiessen-Philbrook; Joseph Ficek; Veena Rao; Patrick Murray; Haiqun Lin; Chirag R Parikh Journal: J Am Soc Nephrol Date: 2015-09-15 Impact factor: 10.121
Authors: I E Hall; B Schröppel; M D Doshi; J Ficek; F L Weng; R D Hasz; H Thiessen-Philbrook; P P Reese; C R Parikh Journal: Am J Transplant Date: 2015-03-11 Impact factor: 8.086
Authors: Isaac E Hall; Peter P Reese; Francis L Weng; Bernd Schröppel; Mona D Doshi; Rick D Hasz; William Reitsma; Michael J Goldstein; Kwangik Hong; Chirag R Parikh Journal: Clin J Am Soc Nephrol Date: 2014-02-20 Impact factor: 8.237
Authors: Isaac E Hall; Peter P Reese; Mona D Doshi; Francis L Weng; Bernd Schröppel; William S Asch; Joseph Ficek; Heather Thiessen-Philbrook; Chirag R Parikh Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: Mona D Doshi; Peter P Reese; Isaac E Hall; Bernd Schröppel; Joseph Ficek; Richard N Formica; Francis L Weng; Rick D Hasz; Heather Thiessen-Philbrook; Chirag R Parikh Journal: Transplantation Date: 2017-06 Impact factor: 4.939
Authors: Nisha Bansal; Myra A Carpenter; Daniel E Weiner; Andrew S Levey; Marc Pfeffer; John W Kusek; Jianwen Cai; Lawrence G Hunsicker; Meyeon Park; Michael Bennett; Kathleen D Liu; Chi-Yuan Hsu Journal: J Am Soc Nephrol Date: 2015-11-04 Impact factor: 10.121