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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Urine Injury Biomarkers Are Not Associated With Kidney Transplant Failure
Transplantation, v 104(6), pp 1272-1279
Jun 2020
PMID: 31568213
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Kidneys transplanted from deceased donors with serum creatinine-defined acute kidney injury (AKI) have similar allograft survival as non-AKI kidneys but are discarded at a higher rate. Urine injury biomarkers are sensitive markers of structural kidney damage and may more accurately predict graft outcomes.
In the 2010-2013 multicenter Deceased Donor Study of 2430 kidney transplant recipients from 1298 donors, we assessed the association of donor urine injury biomarkers microalbumin, neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, IL-18, and liver-type fatty acid binding protein with graft failure (GF) and death-censored GF (dcGF) using Cox proportional hazard models (median follow-up 4 y). We examined if serum creatinine-defined donor AKI modified this association to assess the relationship between subclinical donor AKI (elevated biomarkers without creatinine-defined AKI) and GF. Through chart review of a subcohort (1137 recipients), we determined associations between donor injury biomarkers and a 3-year composite outcome of GF, mortality, or estimated glomerular filtration rate ≤ 20mL/min/1.73m.
Risk of GF, dcGF, and 3-year composite outcome did not vary with donor injury biomarker concentrations after adjusting for donor, transplant, and recipient characteristics (adjusted hazard ratio ranged from 0.96 to 1.01 per log-2 increase in biomarker). Subclinical injury in transplanted kidneys without AKI was not associated with GF.
AKI measured using injury biomarkers was not associated with posttransplant graft outcomes (at median 4 y posttransplant). When assessing posttransplant graft viability, clinicians can prioritize other donor and recipient factors over donor kidney injury, measured by either serum creatinine or urine injury biomarkers.
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Details
- Title
- Urine Injury Biomarkers Are Not Associated With Kidney Transplant Failure
- Creators
- Neel Koyawala - Johns Hopkins UniversityPeter P Reese - University of PennsylvaniaIsaac E Hall - University of UtahYaqi Jia - Johns Hopkins MedicineHeather R Thiessen-Philbrook - Johns Hopkins MedicineSherry G Mansour - Yale UniversityMona D Doshi - University of MichiganEnver Akalin - Albert Einstein College of MedicineJonathan S Bromberg - University of Maryland, BaltimoreMeera N Harhay - Drexel UniversitySumit Mohan - Columbia UniversityThangamani Muthukumar - Cornell UniversityBernd Schröppel - Universität UlmPooja Singh - Thomas Jefferson UniversityFrancis L Weng - Saint Barnabas Medical CenterChirag R Parikh - Johns Hopkins Medicine
- Publication Details
- Transplantation, v 104(6), pp 1272-1279
- Publisher
- Lippincott
- Grant note
- K23 DK105207 / NIDDK NIH HHS UL1 TR002538 / NCATS NIH HHS R01 DK093770 / NIDDK NIH HHS KL2 TR002539 / NCATS NIH HHS P30 DK079310 / NIDDK NIH HHS K24 DK090203 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000537110900033
- Scopus ID
- 2-s2.0-85085184640
- Other Identifier
- 991019335323204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Immunology
- Surgery
- Transplantation