Urine Cystatin C as a Biomarker of Proximal Tubular Function Immediately after Kidney Transplantation

作者:Hall Isaac E; Koyner Jay L; Doshi Mona D; Marcus Richard J; Parikh Chirag R*
来源:American Journal of Nephrology, 2011, 33(5): 407-413.
DOI:10.1159/000326753

摘要

Background/Aims: Clinical methods to predict allograft function soon after kidney transplantation are ineffective. Methods: We analyzed urine cystatin C (CyC) in a prospective multicenter observational cohort study of deceased-donor kidney transplants to determine its peritransplant excretion pattern, utility for predicting delayed graft DGF) and association with 3-month graft function. Serial urine samples were collected for 2 days following transplant and analyzed blindly for CyC. We defined DGF as any hemodialysis in the first week after transplant, slow graft SGF) as a serum creatinine reduction <70% by the first week and immediate graft IGF) as a reduction >= 70%. Results: Of 91 recipients, 33 had DGF, 34 had SGF and 24 had IGF. Urine CyC/urine creatinine was highest in DGF for all time-points. The area under the curve (95% Cl) for predicting DGF at 6 h was 0.69 (0.57-0.81) for urine CyC, 0.74 (0.62-0.86) for urine CyC/urine creatinine and 0.60 (0.45-0.75) for percent change in urine CyC. On the first postoperative day, urine CyC/urine creatinine and percent change in urine CyC were associated with 3-month graft function. Conclusion: Urine CyC on the day after transplant differs between degrees of perioperative graft function and modestly corresponds with 3-month function.

  • 出版日期2011