Changes of Kidney Injury Molecule-1 Expression and Renal Allograft Function in Protocol and for Cause Renal Allograft Biopsy

Background Kidney transplant recipients are a unique cohort in regard to SARS-CoV 2 susceptibility and clinical course, owing to their immunosuppressed state and propensity for kidney injury. The primary purpose of this study is to ascertain if, in kidney transplant recipients, SARS-CoV 2 infection impacts long term renal allograft function. Methods This retrospective, single-center study reviewed 53 kidney transplant recipients with a positive SARS-CoV-2 PCR at NMH from January 1, 2020 to June 30, 2020. Results Change in eGFR from baseline kidney function prior to infection to 90 days after the first positive SARS-CoV 2 test was +1.76%, -17.5% and -23.16% the mild, moderate and severe disease groups respectively. There was a significant decline in kidney function in the moderate and severe disease cohorts as compared to the mild disease cohort, with respective p values of p = 0.0002 and p = 0.021. Relative to the mild disease cohort, the moderate and severe disease cohorts also demonstrated significantly increased risk of developing AKI (66%, 85%), both with p values of P = 0.0001. Conclusions Clinically severe SARS-CoV 2 infection is associated with greater risk of acute kidney injury and greater decline in renal allograft function at 90 days post infection, compared to mild disease.

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Urinary Kidney injury molecule-1 can predict delayed graft function in living donor renal allograft recipients

Nephrology ◽

10.1111/nep.12511 ◽

2015 ◽

Vol 20 (11) ◽

pp. 801-806 ◽

Cited By ~ 6

Author(s):

Brijesh Yadav ◽

Narayan Prasad ◽

Vikas Agrawal ◽

Akhilesh Jaiswal ◽

Vinita Agrawal ◽

...

Keyword(s):

Living Donor ◽

Renal Allograft ◽

Graft Function ◽

Kidney Injury ◽

Delayed Graft Function ◽

Kidney Injury Molecule 1

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Urinary kidney injury molecule-1 can predict acute tubular necrosis in living donor renal allograft recipients

Indian Journal of Transplantation ◽

10.1016/j.ijt.2014.12.014 ◽

2014 ◽

Vol 8 (4) ◽

pp. 130

Author(s):

Narayan Prasad ◽

Brijesh Yadav ◽

Akhilesh Jaiswal ◽

R.K. Sharma ◽

Vikas Agarwal

Keyword(s):

Acute Tubular Necrosis ◽

Living Donor ◽

Renal Allograft ◽

Kidney Injury ◽

Tubular Necrosis ◽

Kidney Injury Molecule 1

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MO967A STUDY OF ACUTE KIDNEY INJURY IN RENAL ALLOGRAFT RECIPIENTS AND ITS IMPACT ON SHORT-TERM OUTCOME OF GRAFT FUNCTION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab110.0046 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Manzoor Parry

Keyword(s):

Acute Kidney Injury ◽

Kidney Disease ◽

Renal Allograft ◽

Graft Function ◽

Kidney Injury ◽

Term Outcome ◽

Post Transplant ◽

Native Kidney ◽

Allograft Function

Abstract Background and Aims Acute kidney injury (AKI) in renal allograft recipients (RAR) is an important factor for short and long-term allograft function and survival. RAR are at high risk of AKI. The etiology, risk factors, and outcomes of AKI in RAR differ from that of AKI in the community setting. This study aimed to evaluate the spectrum and impact of AKI episodes on RAR outcome. Method This was a single-centre, prospective observational study on 84 live RAR patients who developed 105 AKI episodes as per Kidney Disease Improving Global Outcome (KDIGO) criteria between January 2018 to December 2019. The severity of AKI was categorized as per KDIGO guidelines. Acute rejection, recurrence of native kidney disease, and de nova glomerulonephritis were diagnosed by graft biopsy. These patients were followed for 3 months after AKI episodes. Results The mean age of our study populations was 38.1 ± 13.2 years. Mean serum creatinine at the time of AKI episode was 2.63 ± 0.95 mg/dL. The causes of AKI in our study population were infections (n 48, 45.7% ), dehydration (n 25, 23.8%), biopsy-proven rejection (n 9,8.6%) calcineurin inhibitor toxicity (n 10, 9.5%), biopsy-proven acute tubular necrosis (n 4, 3.8%), recurrence of native kidney disease (n 4, 3.8%), and miscellaneous causes (n 5, 4.8%). Most of the AKI episodes (62.9%) developed in the first year of the transplant, while as 29 (27.6%) cases developed between 1st and 2nd post-transplant year and 10 (9.5%) cases developed AKI beyond 2 years post-transplant. Sixty-four cases (60.9%) of AKI were in KDIGO stage 1, 30 cases (28.6%) were in AKI stage 2 and 11 cases (10.5%) were in AKI stage 3. Previous episodes of AKI (p<0.0001), need for dialysis at the time of AKI (p=0.0016), and higher stage of AKI (p<0.0001) were the factors associated with nonrecovery of graft functions at 3 months follow-up. At 3 months of follow up, AKI had a significant impact on allograft function. Conclusion In our study, AKI in RAR had a significant impact on allograft function. Multiple episodes of AKI, need for dialysis, and higher stage of AKI appear to affect the renal recovery at 3 months post-AKI.

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