Urine Liver-Type Fatty Acid-Binding Protein Predicts Graft Outcome up to 2 Years After Kidney Transplantation
- Authors
- Yang, J.; Choi, H. M.; Seo, M. Y.; Lee, J. Y.; Kim, K.; Jun, H.; Jung, C. W.; Park, K. T.; Kim, M. -G.; Jo, S. -K.; Cho, W.; Kim, H. K.
- Issue Date
- 3월-2014
- Publisher
- ELSEVIER SCIENCE INC
- Citation
- TRANSPLANTATION PROCEEDINGS, v.46, no.2, pp.376 - 380
- Indexed
- SCIE
SCOPUS
- Journal Title
- TRANSPLANTATION PROCEEDINGS
- Volume
- 46
- Number
- 2
- Start Page
- 376
- End Page
- 380
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/99126
- DOI
- 10.1016/j.transproceed.2013.11.130
- ISSN
- 0041-1345
- Abstract
- Background. Several new biomarkers for the detection of early tubular injury have been investigated in kidney transplant recipients. We recently identified day 2 urinary neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of slow graft function and adverse 1-year outcome. In the present study, we further investigated the value of urinary NGAL and liver-type fatty acid binding protein (L-FABP) for predicting long-term graft outcomes up to 2 years. Methods. This study was a single-center, prospective observational study. Serial urinary NGAL and L-FABP levels at 0 hours, 2 days, and 6 days after kidney transplantation (KT) were measured, and the clinical data were assessed during the 2-year period after KT. Results. During the 2-year follow-up period, 13 (18.8%), 5 (7.2%), and 4 (5.8%) patients were diagnosed with acute T-cell-mediated rejection, acute antibody-mediated rejection (AMR) and chronic AMR, respectively. In addition, 10 patients (14.3%) developed calcineurin inhibitor toxicity and 6 (8.7%) developed BK viremia. The mean estimated glomerular filtration rates (eGFR) at 1 and 2 years after KT were 65.1 +/- 19.1 and 58.5 +/- 22 6 mL/min/1.73 m(2), respectively, When poor long-term graft function was defined as eGFR of less than 50 mL/min/1.73 m(2) at 2 years, elderly donors, acute rejection, and high 0-hour urinary L-FABP levels were significant risk factors. Furthermore, in rejection-free patients, L-FABP was strongly associated with poor long-term graft function (P = .006). Multivariate logistic regression analysis showed that high 0-hour L-FABP (P = .015) and acute rejection (P = .006) were independent factors predicting poor long-term graft function. Receiver operating characteristic analysis showed that the area under the curve for urinary L-FABP was 0.692 (P = .036). Conclusions. Our results suggest that urinary L-FABP may be a useful predictor of adverse long-term outcomes in KT patients.
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