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Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up

Currently, serum creatinine and estimated glomerular filtration rate (eGFR) together with albuminuria or proteinuria are laboratory markers used in long-term monitoring of kidney transplant recipients. There is a need for more sensitive markers that could serve as early warning signs of graft dysfun...

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Autores principales: Kielar, Małgorzata, Dumnicka, Paulina, Gala-Błądzińska, Agnieszka, Będkowska-Prokop, Alina, Ignacak, Ewa, Maziarz, Barbara, Ceranowicz, Piotr, Kuśnierz-Cabala, Beata
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795618/
https://www.ncbi.nlm.nih.gov/pubmed/33375581
http://dx.doi.org/10.3390/jcm10010043
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author Kielar, Małgorzata
Dumnicka, Paulina
Gala-Błądzińska, Agnieszka
Będkowska-Prokop, Alina
Ignacak, Ewa
Maziarz, Barbara
Ceranowicz, Piotr
Kuśnierz-Cabala, Beata
author_facet Kielar, Małgorzata
Dumnicka, Paulina
Gala-Błądzińska, Agnieszka
Będkowska-Prokop, Alina
Ignacak, Ewa
Maziarz, Barbara
Ceranowicz, Piotr
Kuśnierz-Cabala, Beata
author_sort Kielar, Małgorzata
collection PubMed
description Currently, serum creatinine and estimated glomerular filtration rate (eGFR) together with albuminuria or proteinuria are laboratory markers used in long-term monitoring of kidney transplant recipients. There is a need for more sensitive markers that could serve as early warning signs of graft dysfunction. Our aim was to assess the urinary concentrations of neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of changes in kidney transplant function after the first year post-transplantation. We prospectively recruited 109 patients with functioning graft at least one year after the transplantation, with no acute conditions over the past three months, during their control visits in kidney transplant ambulatory. Urinary NGAL measured on recruitment was twice higher in patients with at least 10% decrease in eGFR over 1-year follow-up compared to those with stable or improving transplant function. Baseline NGAL significantly predicted the relative and absolute changes in eGFR and the mean eGFR during the follow-up independently of baseline eGFR and albuminuria. Moreover, baseline NGAL significantly predicted urinary tract infections during the follow-up, although the infections were not associated with decreasing eGFR. Additionally, we assessed urinary concentrations of matrix metalloproteinase 9—NGAL complex in a subgroup of 77 patients and found higher levels in patients who developed urinary tract infections during the follow-up but not in those with decreasing eGFR. High urinary NGAL in clinically stable kidney transplant recipients beyond the first year after transplantation may be interpreted as a warning and trigger the search for transient or chronic causes of graft dysfunction, or urinary tract infection.
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spelling pubmed-77956182021-01-10 Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up Kielar, Małgorzata Dumnicka, Paulina Gala-Błądzińska, Agnieszka Będkowska-Prokop, Alina Ignacak, Ewa Maziarz, Barbara Ceranowicz, Piotr Kuśnierz-Cabala, Beata J Clin Med Article Currently, serum creatinine and estimated glomerular filtration rate (eGFR) together with albuminuria or proteinuria are laboratory markers used in long-term monitoring of kidney transplant recipients. There is a need for more sensitive markers that could serve as early warning signs of graft dysfunction. Our aim was to assess the urinary concentrations of neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of changes in kidney transplant function after the first year post-transplantation. We prospectively recruited 109 patients with functioning graft at least one year after the transplantation, with no acute conditions over the past three months, during their control visits in kidney transplant ambulatory. Urinary NGAL measured on recruitment was twice higher in patients with at least 10% decrease in eGFR over 1-year follow-up compared to those with stable or improving transplant function. Baseline NGAL significantly predicted the relative and absolute changes in eGFR and the mean eGFR during the follow-up independently of baseline eGFR and albuminuria. Moreover, baseline NGAL significantly predicted urinary tract infections during the follow-up, although the infections were not associated with decreasing eGFR. Additionally, we assessed urinary concentrations of matrix metalloproteinase 9—NGAL complex in a subgroup of 77 patients and found higher levels in patients who developed urinary tract infections during the follow-up but not in those with decreasing eGFR. High urinary NGAL in clinically stable kidney transplant recipients beyond the first year after transplantation may be interpreted as a warning and trigger the search for transient or chronic causes of graft dysfunction, or urinary tract infection. MDPI 2020-12-25 /pmc/articles/PMC7795618/ /pubmed/33375581 http://dx.doi.org/10.3390/jcm10010043 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kielar, Małgorzata
Dumnicka, Paulina
Gala-Błądzińska, Agnieszka
Będkowska-Prokop, Alina
Ignacak, Ewa
Maziarz, Barbara
Ceranowicz, Piotr
Kuśnierz-Cabala, Beata
Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title_full Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title_fullStr Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title_full_unstemmed Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title_short Urinary NGAL Measured after the First Year Post Kidney Transplantation Predicts Changes in Glomerular Filtration over One-Year Follow-Up
title_sort urinary ngal measured after the first year post kidney transplantation predicts changes in glomerular filtration over one-year follow-up
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795618/
https://www.ncbi.nlm.nih.gov/pubmed/33375581
http://dx.doi.org/10.3390/jcm10010043
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