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Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study
Delayed graft function (DGF) following kidney transplantation is associated with increased risk of graft failure, but biomarkers to predict DGF are scarce. We evaluated serum uromodulin (sUMOD), a potential marker for tubular integrity with immunomodulatory capacities, in kidney transplant recipient...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230896/ https://www.ncbi.nlm.nih.gov/pubmed/34208140 http://dx.doi.org/10.3390/jcm10122586 |
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author | Kemmner, Stephan Holzmann-Littig, Christopher Sandberger, Helene Bachmann, Quirin Haberfellner, Flora Torrez, Carlos Schmaderer, Christoph Heemann, Uwe Renders, Lutz Assfalg, Volker El-Achkar, Tarek M. Garimella, Pranav S. Scherberich, Jürgen Steubl, Dominik |
author_facet | Kemmner, Stephan Holzmann-Littig, Christopher Sandberger, Helene Bachmann, Quirin Haberfellner, Flora Torrez, Carlos Schmaderer, Christoph Heemann, Uwe Renders, Lutz Assfalg, Volker El-Achkar, Tarek M. Garimella, Pranav S. Scherberich, Jürgen Steubl, Dominik |
author_sort | Kemmner, Stephan |
collection | PubMed |
description | Delayed graft function (DGF) following kidney transplantation is associated with increased risk of graft failure, but biomarkers to predict DGF are scarce. We evaluated serum uromodulin (sUMOD), a potential marker for tubular integrity with immunomodulatory capacities, in kidney transplant recipients and its association with DGF. We included 239 kidney transplant recipients and measured sUMOD pretransplant and on postoperative Day 1 (POD1) as independent variables. The primary outcome was DGF, defined as need for dialysis within one week after transplantation. In total, 64 patients (27%) experienced DGF. In multivariable logistic regression analysis adjusting for recipient, donor and transplant associated risk factors each 10 ng/mL higher pretransplant sUMOD was associated with 47% lower odds for DGF (odds ratio (OR) 0.53, 95% confidence interval (95%-CI) 0.30–0.82). When categorizing pretransplant sUMOD into quartiles, the quartile with the lowest values had 4.4-fold higher odds for DGF compared to the highest quartile (OR 4.41, 95%-CI 1.54–13.93). Adding pretransplant sUMOD to a model containing established risk factors for DGF in multivariable receiver-operating-characteristics (ROC) curve analysis, the area-under-the-curve improved from 0.786 [95%-CI 0.723–0.848] to 0.813 [95%-CI 0.755–0.871, p = 0.05]. SUMOD on POD1 was not associated with DGF. In conclusion, higher pretransplant sUMOD was independently associated with lower odds for DGF, potentially serving as a non-invasive marker to stratify patients according to their risk for developing DGF early in the setting of kidney transplantation. |
format | Online Article Text |
id | pubmed-8230896 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82308962021-06-26 Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study Kemmner, Stephan Holzmann-Littig, Christopher Sandberger, Helene Bachmann, Quirin Haberfellner, Flora Torrez, Carlos Schmaderer, Christoph Heemann, Uwe Renders, Lutz Assfalg, Volker El-Achkar, Tarek M. Garimella, Pranav S. Scherberich, Jürgen Steubl, Dominik J Clin Med Article Delayed graft function (DGF) following kidney transplantation is associated with increased risk of graft failure, but biomarkers to predict DGF are scarce. We evaluated serum uromodulin (sUMOD), a potential marker for tubular integrity with immunomodulatory capacities, in kidney transplant recipients and its association with DGF. We included 239 kidney transplant recipients and measured sUMOD pretransplant and on postoperative Day 1 (POD1) as independent variables. The primary outcome was DGF, defined as need for dialysis within one week after transplantation. In total, 64 patients (27%) experienced DGF. In multivariable logistic regression analysis adjusting for recipient, donor and transplant associated risk factors each 10 ng/mL higher pretransplant sUMOD was associated with 47% lower odds for DGF (odds ratio (OR) 0.53, 95% confidence interval (95%-CI) 0.30–0.82). When categorizing pretransplant sUMOD into quartiles, the quartile with the lowest values had 4.4-fold higher odds for DGF compared to the highest quartile (OR 4.41, 95%-CI 1.54–13.93). Adding pretransplant sUMOD to a model containing established risk factors for DGF in multivariable receiver-operating-characteristics (ROC) curve analysis, the area-under-the-curve improved from 0.786 [95%-CI 0.723–0.848] to 0.813 [95%-CI 0.755–0.871, p = 0.05]. SUMOD on POD1 was not associated with DGF. In conclusion, higher pretransplant sUMOD was independently associated with lower odds for DGF, potentially serving as a non-invasive marker to stratify patients according to their risk for developing DGF early in the setting of kidney transplantation. MDPI 2021-06-11 /pmc/articles/PMC8230896/ /pubmed/34208140 http://dx.doi.org/10.3390/jcm10122586 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kemmner, Stephan Holzmann-Littig, Christopher Sandberger, Helene Bachmann, Quirin Haberfellner, Flora Torrez, Carlos Schmaderer, Christoph Heemann, Uwe Renders, Lutz Assfalg, Volker El-Achkar, Tarek M. Garimella, Pranav S. Scherberich, Jürgen Steubl, Dominik Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title | Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title_full | Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title_fullStr | Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title_full_unstemmed | Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title_short | Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study |
title_sort | pretransplant serum uromodulin and its association with delayed graft function following kidney transplantation—a prospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230896/ https://www.ncbi.nlm.nih.gov/pubmed/34208140 http://dx.doi.org/10.3390/jcm10122586 |
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