A comparison of alternative serum biomarkers with creatinine for predicting allograft function after kidney transplantation

Isaac E. Hall, Mona D. Doshi, Emilio D. Poggio, Chirag Parikh

Research output: Contribution to journalArticle

Abstract

Background: The role of serum cystatin C (Scyc), neutrophil gelatinase-associated lipocalin, and interleukin-18 in predicting early graft function after kidney transplant is poorly defined. Methods: We conducted a multicenter prospective cohort study of deceased-donor kidney transplants. We collected serial blood samples for the first 3 days of transplant and monitored need for dialysis within 1 week and graft function at 3 months after transplant. Results: Among 78 recipients with serum biomarker measurements, 26 had delayed graft function (DGF; hemodialysis within 1 week of transplant). Of those not dialyzed, 29 had slow graft function (serum creatinine [Scr] reduction from transplantation to day 7 < 70%), and 23 had immediate graft function (IGF; reduction in Scr ≥70%). Scyc levels were statistically different between groups by the first postoperative day (POD), whereas Scr levels were not. Serum neutrophil gelatinase-associated lipocalin and serum interleukin-18 levels were not different between groups. Scyc on the first POD demonstrated good utility for predicting DGF and non-IGF (DGF or slow graft function) with areas under the receiver-operating characteristic curve of 0.83 and 0.85, respectively. Areas under the receiver-operating characteristic curve for predicting DGF and non-IGF using Scr on the first POD were 0.65 and 0.53, respectively. Substituting Scyc for Scr in a clinical algorithm improved its utility for predicting DGF or non-IGF, with adjusted odds ratios of 2.4 and 3.3 for Scyc levels on the first POD. The change in Scyc during the first POD demonstrated a dose-response relationship with 3-month graft function. Conclusions. Scyc outperforms Scr as a predictor of early graft function after deceased-donor kidney transplant.

Original languageEnglish (US)
Pages (from-to)48-56
Number of pages9
JournalTransplantation
Volume91
Issue number1
DOIs
StatePublished - Jan 15 2011

Fingerprint

Kidney Transplantation
Allografts
Creatinine
Biomarkers
Cystatin C
Transplants
Serum
Interleukin-18
Kidney
ROC Curve
Delayed Graft Function
Renal Dialysis
Dialysis
Cohort Studies
Transplantation

Keywords

  • Delayed graft function
  • Kidney transplantation
  • Serum cystatin C
  • Serum IL-18
  • Serum NGAL

ASJC Scopus subject areas

  • Transplantation

Cite this

A comparison of alternative serum biomarkers with creatinine for predicting allograft function after kidney transplantation. / Hall, Isaac E.; Doshi, Mona D.; Poggio, Emilio D.; Parikh, Chirag.

In: Transplantation, Vol. 91, No. 1, 15.01.2011, p. 48-56.

Research output: Contribution to journalArticle

@article{03c363b3fdc44f0e9e72c30ae61eafab,
title = "A comparison of alternative serum biomarkers with creatinine for predicting allograft function after kidney transplantation",
abstract = "Background: The role of serum cystatin C (Scyc), neutrophil gelatinase-associated lipocalin, and interleukin-18 in predicting early graft function after kidney transplant is poorly defined. Methods: We conducted a multicenter prospective cohort study of deceased-donor kidney transplants. We collected serial blood samples for the first 3 days of transplant and monitored need for dialysis within 1 week and graft function at 3 months after transplant. Results: Among 78 recipients with serum biomarker measurements, 26 had delayed graft function (DGF; hemodialysis within 1 week of transplant). Of those not dialyzed, 29 had slow graft function (serum creatinine [Scr] reduction from transplantation to day 7 < 70{\%}), and 23 had immediate graft function (IGF; reduction in Scr ≥70{\%}). Scyc levels were statistically different between groups by the first postoperative day (POD), whereas Scr levels were not. Serum neutrophil gelatinase-associated lipocalin and serum interleukin-18 levels were not different between groups. Scyc on the first POD demonstrated good utility for predicting DGF and non-IGF (DGF or slow graft function) with areas under the receiver-operating characteristic curve of 0.83 and 0.85, respectively. Areas under the receiver-operating characteristic curve for predicting DGF and non-IGF using Scr on the first POD were 0.65 and 0.53, respectively. Substituting Scyc for Scr in a clinical algorithm improved its utility for predicting DGF or non-IGF, with adjusted odds ratios of 2.4 and 3.3 for Scyc levels on the first POD. The change in Scyc during the first POD demonstrated a dose-response relationship with 3-month graft function. Conclusions. Scyc outperforms Scr as a predictor of early graft function after deceased-donor kidney transplant.",
keywords = "Delayed graft function, Kidney transplantation, Serum cystatin C, Serum IL-18, Serum NGAL",
author = "Hall, {Isaac E.} and Doshi, {Mona D.} and Poggio, {Emilio D.} and Chirag Parikh",
year = "2011",
month = "1",
day = "15",
doi = "10.1097/TP.0b013e3181fc4b3a",
language = "English (US)",
volume = "91",
pages = "48--56",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - A comparison of alternative serum biomarkers with creatinine for predicting allograft function after kidney transplantation

AU - Hall, Isaac E.

AU - Doshi, Mona D.

AU - Poggio, Emilio D.

AU - Parikh, Chirag

PY - 2011/1/15

Y1 - 2011/1/15

N2 - Background: The role of serum cystatin C (Scyc), neutrophil gelatinase-associated lipocalin, and interleukin-18 in predicting early graft function after kidney transplant is poorly defined. Methods: We conducted a multicenter prospective cohort study of deceased-donor kidney transplants. We collected serial blood samples for the first 3 days of transplant and monitored need for dialysis within 1 week and graft function at 3 months after transplant. Results: Among 78 recipients with serum biomarker measurements, 26 had delayed graft function (DGF; hemodialysis within 1 week of transplant). Of those not dialyzed, 29 had slow graft function (serum creatinine [Scr] reduction from transplantation to day 7 < 70%), and 23 had immediate graft function (IGF; reduction in Scr ≥70%). Scyc levels were statistically different between groups by the first postoperative day (POD), whereas Scr levels were not. Serum neutrophil gelatinase-associated lipocalin and serum interleukin-18 levels were not different between groups. Scyc on the first POD demonstrated good utility for predicting DGF and non-IGF (DGF or slow graft function) with areas under the receiver-operating characteristic curve of 0.83 and 0.85, respectively. Areas under the receiver-operating characteristic curve for predicting DGF and non-IGF using Scr on the first POD were 0.65 and 0.53, respectively. Substituting Scyc for Scr in a clinical algorithm improved its utility for predicting DGF or non-IGF, with adjusted odds ratios of 2.4 and 3.3 for Scyc levels on the first POD. The change in Scyc during the first POD demonstrated a dose-response relationship with 3-month graft function. Conclusions. Scyc outperforms Scr as a predictor of early graft function after deceased-donor kidney transplant.

AB - Background: The role of serum cystatin C (Scyc), neutrophil gelatinase-associated lipocalin, and interleukin-18 in predicting early graft function after kidney transplant is poorly defined. Methods: We conducted a multicenter prospective cohort study of deceased-donor kidney transplants. We collected serial blood samples for the first 3 days of transplant and monitored need for dialysis within 1 week and graft function at 3 months after transplant. Results: Among 78 recipients with serum biomarker measurements, 26 had delayed graft function (DGF; hemodialysis within 1 week of transplant). Of those not dialyzed, 29 had slow graft function (serum creatinine [Scr] reduction from transplantation to day 7 < 70%), and 23 had immediate graft function (IGF; reduction in Scr ≥70%). Scyc levels were statistically different between groups by the first postoperative day (POD), whereas Scr levels were not. Serum neutrophil gelatinase-associated lipocalin and serum interleukin-18 levels were not different between groups. Scyc on the first POD demonstrated good utility for predicting DGF and non-IGF (DGF or slow graft function) with areas under the receiver-operating characteristic curve of 0.83 and 0.85, respectively. Areas under the receiver-operating characteristic curve for predicting DGF and non-IGF using Scr on the first POD were 0.65 and 0.53, respectively. Substituting Scyc for Scr in a clinical algorithm improved its utility for predicting DGF or non-IGF, with adjusted odds ratios of 2.4 and 3.3 for Scyc levels on the first POD. The change in Scyc during the first POD demonstrated a dose-response relationship with 3-month graft function. Conclusions. Scyc outperforms Scr as a predictor of early graft function after deceased-donor kidney transplant.

KW - Delayed graft function

KW - Kidney transplantation

KW - Serum cystatin C

KW - Serum IL-18

KW - Serum NGAL

UR - http://www.scopus.com/inward/record.url?scp=78751662129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78751662129&partnerID=8YFLogxK

U2 - 10.1097/TP.0b013e3181fc4b3a

DO - 10.1097/TP.0b013e3181fc4b3a

M3 - Article

C2 - 21441853

AN - SCOPUS:78751662129

VL - 91

SP - 48

EP - 56

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 1

ER -