scholarly journals Comparative Assessment of uNGAL, uNAG and Cystatin C As Early Biomarkers in Renal Post-Transplant Patients

2018 ◽  
Vol 45 (2) ◽  
pp. 12-19
Author(s):  
G. Nikolov ◽  
M. Boncheva ◽  
T. Gruev ◽  
K. T. Trajkovska ◽  
I. Kostovska
Keyword(s):  
Serum Creatinine ◽  
Cystatin C ◽  
Graft Function ◽  
Roc Curves ◽  
Urinary Ngal ◽  
Kidney Transplant Recipients ◽  
Serum Cystatin C ◽  
Post Transplantation ◽  
Post Transplant ◽  
One Year

Abstract Urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary N-acetyl-bd-glucosaminidase (NAG), urinary α1-microglobulin/creatinine ratio and cystatin C have been suggested as potential early markers of delayed graft function (DGF) following kidney transplantation. We conducted a prospective study in 50 consecutive kidney transplant recipients to evaluate serial changes of these biomarkers within the first week after transplantation and assess their performance in predicting DGF (dialysis requirement during initial post-transplant week) and graft function throughout the first year. Urine samples were collected on post-transplantation days 0, 1, 2, 4, and 7. Statistical analysis: Linear mixed and multivariable regression models, receiver-operating characteristic (ROC), and areas under ROC curves were used. At all-time points, mean urinary NGAL levels were significantly higher in patients developing DGF. Shortly after transplantation (3-6 h), uNGAL and uNAG values were higher in DGF recipients (on average +242 ng/mL; NAG – 6.8 U/mmol creatinine, considering mean dialysis time of 4.1 years) and rose further in the following days, contrasting with prompt function recipients. On 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 level. Urinary NGAL, serum cystatin C is an early marker of graft injury and is independently associated with dialysis requirement within one week after transplantation and one-year graft function.

scholarly journals Serum Cystatin C in Patients with Delayed Graft Function

2016 ◽  
Vol 43 (1) ◽  
pp. 14-22
Author(s):  
M. Boncheva ◽  
T. Gruev ◽  
G. Nikolov
Keyword(s):  
Cystatin C ◽  
Graft Function ◽  
High Sensitivity ◽  
Acute Rejection Episode ◽  
Serum Cystatin C ◽  
Post Transplantation ◽  
Creatinine Concentration ◽  
Serum Cystatin ◽  
The Mean ◽  
Kinetics Of

SummaryDespite recent studies showing that serum Cystatin C (CysC) is a better marker for glomerular filtration rate (GFR) than the ubiquitously used creatinine, the clinical utility of these findings remains to be evaluated. This marker is very sensitive for allograft function after renal transplantation. The concentration of CysC was compared with that of the creatinine. Decreased renal function was followed in 64 transplanted patients. Serum CysC significantly correlated with creatinine in healthy controls (r = 0.625, p < 0.0001), whereas in the transplanted patients the mean serum creatinine and CysC concentrations were: 81 ± 13 mmol/L and 0.90 ± 0.22 mg/L, respectively. Serum CysC and creatinine significantly correlated throughout the post transplantation period (r = 0.686, p < 0.001), but we confirmed differences between kinetics of these parameters. In the first four days after transplantation the CysC concentration was normalized faster than the creatinine concentration. Development of acute rejection episode (between 5 and 7 days) showed high sensitivity and specificity of the changes of CysC compared with those of creatinine.

scholarly journals Neutrophil Gelatinase-Associated Lipocalin in Kidney Transplantation Is an Early Marker of Graft Dysfunction and Is Associated with One-Year Renal Function

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Isabel Fonseca ◽  
José Carlos Oliveira ◽  
Manuela Almeida ◽  
Madalena Cruz ◽  
Anabela Malho ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Graft Function ◽  
Roc Curves ◽  
First Year ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Early Marker ◽  
One Year ◽  
A Prospective Study ◽  
Neutrophil Gelatinase

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.

scholarly journals Early Identification of Acute Kidney Injury after Bariatric Surgery: Role of NGAL and Cystatin C

2014 ◽  
Vol 6 (1) ◽  
pp. 50-59
Author(s):  
Sidoti Anna ◽  
Giacalone Marilu ◽  
Abramo Antonio ◽  
Anselmino Marco ◽  
Carlo Donadio ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
Paired Data ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Significant Difference

Background: The aim of our study was to evaluate plasmatic and urinary NGAL and serum cystatin C as early diagnostic markers of acute kidney injury in obese patients undergoing bariatric surgery. Methods: For this this prospective observational study, we recruited 23 patients undergoing gastric by-pass or sleeve gastrectomy, and admitted to the Low Dependence Unit after the surgery. Plasma NGAL (pNGAL), urinary NGAL (uNGAL), serum cystatin C, serum creatinine, and serum urea were measured before surgery as well as 10 h and 24 h after surgery. Mean values of pNGAL, uNGAL, cystatin C, creatinine, and urea concentrations of pre- and post-surgery periods were compared using Student’s t test for paired data. We also evaluated the presence of correlation between modifications of NGAL and cystatin C after surgery and fluid balance, hydration (ml/kg) and diuresis using Pearson’s coefficient of correlation. Results: No patient developed AKI according to the AKIN criteria. pNGAL was significantly higher at T10h than T0 (p=0.004). There was no significant difference between uNGAL at T0 and T10h (p=0.53) and between uNGAL at T0 and T24h (p=0.31). uNGAL at T was significantly higher in comparison to T10h (p=0.024). uNGAL concentrations were normal in all patients at every time step. Cystatin C concentration did not increase after surgery. Serum creatinine level was significantly higher at T48h, despite being still within the normal range, when compared to T0 (p=0.038). Conclusion: Our study shows that pNGAL can reflect mild tubular damage as its levels increase within a few hours from surgery and return to normal limits afterwards. Concerning uNGAL, there is a minimal increase at T24h, when NGAL concentration in plasma has already decreased. Serum cystatin C does not show any relevant kidney changes, or at least, no more than those ones shown by pNGAL.

scholarly journals A Comparison of Allograft Survival Between Cyclosporine and Tacrolimus Based Immunosuppressive Therapy in Kidney Transplantation: BIRDEM General Hospital Experience

2016 ◽  
Vol 5 (2) ◽  
pp. 78-81
Author(s):  
Palash Mitra ◽  
Md Anisur Rahman ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
Tasrina Shamnaz Samdani ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Immunosuppressive Therapy ◽  
Graft Survival ◽  
Graft Function ◽  
Calcineurin Inhibitors ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Group 2 ◽  
Group 1

Introduction and Aims: Calcineurin inhibitors (CNIs), cyclosporine and tacrolimus, are one of the three major components of basic immunosuppressive therapy of kidney transplantation. Our aims were to study and compare the early and long-term graft survival in kidney transplant recipients who were receiving either of these two CNIs.Methods: A questionnaire was formed and data were collected from the hospital records. We divided the patients in group 1 (patients on cyclosporine) and group 2 (patients on tacrolimus). We retrospectively evaluated patients’ clinical and laboratory findings.Results: Group 1 included 50 patients who were on cyclosporine and group 2 included 61 patients who were on tacrolimus. Patients receiving tacrolimus showed almost similar renal function as cyclosporine receiving patients; serum creatinine was 1.27 ± 0.56 versus 1.42 ± 0.91mg/dL (p = 0.258), but they required less time for serum creatinine to become normal (4.71 ± 2.3 versus 7.26 ± 5.6 days, p=0.001) and less duration of post-transplant hospital stay (11.38 ± 3.33 versus 13.65 ± 5.0 days, p = 0.005). New onset diabetes was more pronounced in group 2 (29.5% versus 12 %, p = 0.025). On the other hand, acute rejection was only noted in group 1 (2 versus 0, p = 0.014). One-year and three-year graft survival for cyclosporine was 92.0% and 83.3%, and for tacrolimus was 96.2% and 89.2% respectively.Conclusions: Tacrolimus is relatively favourable to cyclosporine in preventing acute allograft rejection and better immediate post-transplant graft function recovery.Birdem Med J 2015; 5(2): 78-81

scholarly journals Serum Cistatin C in patients with delayed graft function

2005 ◽  
Vol 51 ◽  
pp. 35-40
Author(s):  
Todor Gruev ◽  
Margarita Boncheva ◽  
Olivera Stojceva-Taneva ◽  
Angel Mitrevski ◽  
Vasko Aleksovski
Keyword(s):  
Cystatin C ◽  
Graft Function ◽  
High Sensitivity ◽  
Acute Rejection Episode ◽  
Serum Cystatin C ◽  
Post Transplantation ◽  
Creatinine Concentration ◽  
Serum Cystatin ◽  
The Mean ◽  
Kinetics Of

Despite recent studies showing that serum Cystatin C(CysC) is a better marker for glomerular filtration rate (GFR) than the ubiquitously used creatinine, the clinical utility of this remains to be evaluated. This marker is very sensitive for alograft function after renal transplantation. Concentration of CysC was compared with that of creatinine. Decreased renal function was followed in 64 transplanted patients. Plasma CysC significantly correlated (r=0.625, p<0.001) with creatinine in healthy controls. In these patients the mean plasma creatinine and Cystatin C concentrations were: 81+/-13 mmol/L,0.90 +/-0.22 mg/L, respectively. Plasma Cystatin C and creatinine significantly correlated throughout the post-transplantation period (r=0.686, p<0.001), but we confirmed differences between kinetics of these parameters. In the first four days after transplantation the CysC concentration was normalized faster than creatinine concentration. Development of acute rejection episode ( between 5 and 7 days) showed high sensitivity and specificity of the changes of CysC compared with those of creatinine.

scholarly journals Clinical relevance of cell-free mitochondrial DNA during the early postoperative period in kidney transplant recipients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kipyo Kim ◽  
Haena Moon ◽  
Yu Ho Lee ◽  
Jung-Woo Seo ◽  
Yang Gyun Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Mitochondrial Dna ◽  
Acute Rejection ◽  
Quantitative Polymerase Chain Reaction ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Post Transplant

AbstractRecent studies indicate that urinary mitochondrial DNA (mtDNA) is predictive of ischemic AKI and is related to delayed graft function (DGF) in renal transplantation. Nevertheless, the clinical implications and prognostic value of urinary mtDNA in kidney transplantation remain undetermined. Here, we aimed to evaluate the associations between cell-free mtDNA and clinical parameters, including pathological findings in allograft biopsy and post-transplant renal function. A total of 85 renal transplant recipients were enrolled, and blood and urine samples were collected at a median of 17 days after transplantation. Cell-free nuclear and mtDNA levels were measured by quantitative polymerase chain reaction for LPL and ND1 genes. Urinary cell-free mtDNA levels were significantly higher in patients with DGF (P < 0.001) and cases of deceased donor transplantation (P < 0.001). The subjects with acute rejection showed higher urinary mtDNA levels than those without abnormalities (P = 0.043). In addition, allograft functions at 9- and 12-month post-transplantation were significantly different between tertile groups of mtDNA independent of the presence of DGF or acute rejection, showing significantly better graft outcome in the lowest tertile group. Urinary cell-free mtDNA levels during the early post-transplant period are significantly associated with DGF, acute rejection in graft biopsy, and short-term post-transplant renal function.

scholarly journals Reference intervals for serum cystatin C and serum creatinine in an adult sub-Saharan African population

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bertille Elodie Edinga-Melenge ◽  
Adrienne Tchapmi Yakam ◽  
Jobert Richie Nansseu ◽  
Catherine Bilong ◽  
Suzanne Belinga ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Cystatin C ◽  
Reference Intervals ◽  
African Population ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Sub Saharan

scholarly journals B-cell activating factor BAFF as a novel alert marker for the immunological risk stratification after kidney transplantation

2021 ◽  
Author(s):  
Antonia Margarete Schuster ◽  
N. Miesgang ◽  
L. Steines ◽  
C. Bach ◽  
B. Banas ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
B Cell ◽  
Graft Function ◽  
Risk Profile ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor ◽  
Medium Risk ◽  
Patients At Risk

AbstractThe B cell activating factor BAFF has gained importance in the context of kidney transplantation due to its role in B cell survival. Studies have shown that BAFF correlates with an increased incidence of antibody-mediated rejection and the development of donor-specific antibodies. In this study, we analyzed a defined cohort of kidney transplant recipients who were treated with standardized immunosuppressive regimens according to their immunological risk profile. The aim was to add BAFF as an awareness marker in the course after transplantation to consider patient’s individual immunological risk profile. Included patients were transplanted between 2016 and 2018. Baseline data, graft function, the occurrence of rejection episodes, signs of microvascular infiltration, and DSA kinetics were recorded over 3 years. BAFF levels were determined 14 d, 3 and 12 months post transplantation. Although no difference in graft function could be observed, medium-risk patients showed a clear dynamic in their BAFF levels with low levels shortly after transplantation and an increase in values of 123% over the course of 1 year. Patients with high BAFF values were more susceptible to rejection, especially antibody-mediated rejection and displayed intensified microvascular inflammation; the combination of high BAFF + DSA puts patients at risk. The changing BAFF kinetics of the medium risk group as well as the increased occurrence of rejections at high BAFF values enables BAFF to be seen as an awareness factor. To compensate the changing immunological risk, a switch from a weaker induction therapy to an intensified maintenance therapy is required.

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