Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function
Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been suggested as potential early marker of delayed graft function (DGF) following kidney transplantation (KTx). We conducted a prospective study in 40 consecutive KTx recipients to evaluate serial changes of uNGAL within the first week...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2013/650123 |
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| author | Isabel Fonseca José Carlos Oliveira Manuela Almeida Madalena Cruz Anabela Malho La Salete Martins Leonídio Dias Sofia Pedroso Josefina Santos Luísa Lobato António Castro Henriques Denisa Mendonça |
| author_facet | Isabel Fonseca José Carlos Oliveira Manuela Almeida Madalena Cruz Anabela Malho La Salete Martins Leonídio Dias Sofia Pedroso Josefina Santos Luísa Lobato António Castro Henriques Denisa Mendonça |
| author_sort | Isabel Fonseca |
| collection | DOAJ |
| description | Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been suggested as potential early marker of delayed graft function (DGF) following kidney transplantation (KTx). We conducted a prospective study in 40 consecutive KTx recipients to evaluate serial changes of uNGAL within the first week after KTx and assess its performance in predicting DGF (dialysis requirement during initial posttransplant week) and graft function throughout first year. Urine samples were collected on post-KTx days 0, 1, 2, 4, and 7. Linear mixed and multivariable regression models, receiver-operating characteristic (ROC), and areas under ROC curves were used. At all-time points, mean uNGAL levels were significantly higher in patients developing DGF (n=18). Shortly after KTx (3–6 h), uNGAL values were higher in DGF recipients (on average +242 ng/mL, considering mean dialysis time of 4.1 years) and rose further in following days, contrasting with prompt function recipients. Day-1 uNGAL levels accurately predicted DGF (AUC-ROC = 0.93), with a performance higher than serum creatinine (AUC-ROC = 0.76), and similar to cystatin C (AUC-ROC = 0.95). Multivariable analyses revealed that uNGAL levels at days 4 and 7 were strongly associated with one-year serum creatinine. Urinary NGAL is an early marker of graft injury and is independently associated with dialysis requirement within one week after KTx and one-year graft function. |
| format | Article |
| id | doaj-art-74e53cff70e84c91888a6926b7a8e067 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-74e53cff70e84c91888a6926b7a8e0672025-02-03T01:23:55ZengWileyJournal of Transplantation2090-00072090-00152013-01-01201310.1155/2013/650123650123Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal FunctionIsabel Fonseca0José Carlos Oliveira1Manuela Almeida2Madalena Cruz3Anabela Malho4La Salete Martins5Leonídio Dias6Sofia Pedroso7Josefina Santos8Luísa Lobato9António Castro Henriques10Denisa Mendonça11Department of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Chemical Chemistry, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Chemical Chemistry, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalDepartment of Nephrology and Kidney Transplantation, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, PortugalInstitute of Public Health (ISPUP), University of Porto, 4050-600 Porto, PortugalUrinary neutrophil gelatinase-associated lipocalin (uNGAL) has been suggested as potential early marker of delayed graft function (DGF) following kidney transplantation (KTx). We conducted a prospective study in 40 consecutive KTx recipients to evaluate serial changes of uNGAL within the first week after KTx and assess its performance in predicting DGF (dialysis requirement during initial posttransplant week) and graft function throughout first year. Urine samples were collected on post-KTx days 0, 1, 2, 4, and 7. Linear mixed and multivariable regression models, receiver-operating characteristic (ROC), and areas under ROC curves were used. At all-time points, mean uNGAL levels were significantly higher in patients developing DGF (n=18). Shortly after KTx (3–6 h), uNGAL values were higher in DGF recipients (on average +242 ng/mL, considering mean dialysis time of 4.1 years) and rose further in following days, contrasting with prompt function recipients. Day-1 uNGAL levels accurately predicted DGF (AUC-ROC = 0.93), with a performance higher than serum creatinine (AUC-ROC = 0.76), and similar to cystatin C (AUC-ROC = 0.95). Multivariable analyses revealed that uNGAL levels at days 4 and 7 were strongly associated with one-year serum creatinine. Urinary NGAL is an early marker of graft injury and is independently associated with dialysis requirement within one week after KTx and one-year graft function.http://dx.doi.org/10.1155/2013/650123 |
| spellingShingle | Isabel Fonseca José Carlos Oliveira Manuela Almeida Madalena Cruz Anabela Malho La Salete Martins Leonídio Dias Sofia Pedroso Josefina Santos Luísa Lobato António Castro Henriques Denisa Mendonça Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function Journal of Transplantation |
| title | Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function |
| title_full | Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function |
| title_fullStr | Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function |
| title_full_unstemmed | Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function |
| title_short | Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function |
| title_sort | neutrophil gelatinase associated lipocalin in kidney transplantation is an early marker of graft dysfunction and is associated with one year renal function |
| url | http://dx.doi.org/10.1155/2013/650123 |
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