Journal
AMERICAN JOURNAL OF NEPHROLOGY
Volume 33, Issue 5, Pages 407-413Publisher
KARGER
DOI: 10.1159/000326753
Keywords
Transplantation; Biomarkers; Ischemia/reperfusion; Outcomes
Categories
Funding
- National Institutes of Health (NIH) [F32DK088395]
- NIH [K23DK81616, UL1RR024139]
- Donaghue Foundation
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR024139] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [K23DK081616, T32DK007276, F32DK088395] Funding Source: NIH RePORTER
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Background/Aims: Clinical methods to predict allograft function soon after kidney transplantation are ineffective. Methods: We analyzed urine cystatin C (CyC) in a prospective multicenter observational cohort study of deceased-donor kidney transplants to determine its peritransplant excretion pattern, utility for predicting delayed graft function (DGF) and association with 3-month graft function. Serial urine samples were collected for 2 days following transplant and analyzed blindly for CyC. We defined DGF as any hemodialysis in the first week after transplant, slow graft function (SGF) as a serum creatinine reduction <70% by the first week and immediate graft function (IGF) as a reduction >= 70%. Results: Of 91 recipients, 33 had DGF, 34 had SGF and 24 had IGF. Urine CyC/urine creatinine was highest in DGF for all time-points. The area under the curve (95% Cl) for predicting DGF at 6 h was 0.69 (0.57-0.81) for urine CyC, 0.74 (0.62-0.86) for urine CyC/urine creatinine and 0.60 (0.45-0.75) for percent change in urine CyC. On the first postoperative day, urine CyC/urine creatinine and percent change in urine CyC were associated with 3-month graft function. Conclusion: Urine CyC on the day after transplant differs between degrees of perioperative graft function and modestly corresponds with 3-month function. Copyright (C) 2011 S. Karger AG, Basel
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