Association between graft function and serum TNF-α, TNFR1 and TNFR2 levels in patients with kidney transplantation

Figures & data

Table 1. General characteristics and demographics features of patients and donors.

Parameters
Donors	Age (year)	46.66 ± 10.65
	Gender
	Male	19 (38%)
	Female	31 (62%)
Patients	Age (year)	38.36 ± 12.88
	Gender
	Male	33 (66%)
	Female	17 (34%)
	BMI (kg/m^2)	23.57 ± 4.17
	Renal replacement therapy modalities (RRT)
	Preemptive	9 (18%)
	PD	3 (6%)
	HD	38 (76%)
	RRT time (month)	18 (0–204)
	CKD etiology
	HT	10 (20%)
	DM	6 (12%)
	Other	34 (68%)
	HLA mismatch
	0	9 (18%)
	1–5	39 (78%)
	6	2 (4%)
	No. HLA-DR mismatch	16 (32%)
	Serum Cr levels  (discharge time) (mg/dL)	1.55 ± 1.11

Notes: CKD: chronic kidney disease, HT: hypertension, DM: diabetes mellitus, PD: peritoneal dialysis, HD: hemodialysis, HLA: human leucocyte antigen, BMI: body mass index.

Figure 1. Comparison of serum creatinine levels before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Figure 2. Comparison of serum cystatin-C levels before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Figure 3. Comparison of serum TNF-alpha levels before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Figure 4. Comparison of serum TNFR1 levels before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Figure 5. Comparison of serum TNFR2 levels before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Figure 6. Comparison of eGFR values before and after transplantation at day 7, month 1 and month 3. Patients (n = 50) were classified to their graft functions and acute rejection episodes.

Table 2. Serum creatinine, cystatin-C, TNF-α, TNFR1, TNFR2 levels and eGFR values before and after transplantation at day 7, month 1 and month 3.

Parameter	Time	IGF (n = 33)	SGF (n = 17)	AR(+) (n = 6)	AR(−) (n = 44)
Creatinine (mg/dL)	Pretx	7.7 ± 0.48	3.82 ± 0.36	7.12 ± 1.15	6.47 ± 0.45
	7th day	1.25 ± 0.05	1.46 ± 0.12	3.46 ± 1.01	1.29 ± 0.05
	Month 1	1.12 ± 0.05	1.34 ± 0.09	1.54 ± 0.21	1.17 ± 0.04
	Month 3	1.18 ± 0.05	1.2 ± 0.07	1.46 ± 0.26	1.18 ± 0.04
Cystatin-C (mg/L)	Pretx	6.12 ± 0.34	5.98 ± 0.38	6.04 ± 0.51	6.11 ± 0.27
	7th day	1.57 ± 0.06	2.31 ± 0.38	3.49 ± 0.79	1.63 ± 0.05
	Month 1	1.48 ± 0.04	1.78 ± 0.14	1.89 ± 0.23	1.53 ± 0.05
	Month 3	1.37 ± 0.04	1.57 ± 0.11	1.71 ± 0.24	1.4 ± 0.03
TNF-α (pg/mL)	Pretx	27.44 ± 3.18	28.77 ± 2.93	30.79 ± 5.96	27.95 ± 2.43
	7th day	13.21 ± 1.64	15.83 ± 3.21	26.53 ± 6.04	12.86 ± 1.3
	Month 1	8.48 ± 0.85	11.75 ± 2.29	13.73 ± 2.07	9.44 ± 0.96
	Month 3	12.42 ± 2.4	10.11 ± 1.45	9.25 ± 1.94	11.75 ± 1.75
TNFR1 (ng/mL)	Pretx	44.75 ± 10.33	31.77 ± 3.77	55.96 ± 21.6	40.52 ± 7.41
	7th day	4.65 ± 0.27	7.73 ± 2.42	15.93 ± 5.76	4.79 ± 0.24
	Month 1	3.56 ± 0.16	4.34 ± 0.49	6.03 ± 0.68	3.73 ± 0.19
	Month 3	3.61 ± 0.18	4.3 ± 0.48	4.09 ± 0.6	3.79 ± 0.2
TNFR2 (ng/mL)	Pretx	50.92 ± 4.12	51.9 ± 5.08	58.31 ± 8.06	50.9 ± 3.34
	7th day	13.78 ± 0.87	20.15 ± 4.21	43.05 ± 9.18	14.13 ± 0.76
	Month 1	9.33 ± 0.46	12.84 ± 1.67	18.59 ± 3.22	9.95 ± 0.5
	Month 3	9.44 ± 0.79	11.22 ± 0.92	10.95 ± 1.8	9.78 ± 0.61
CKD-EPI (mL/dk)	Pretx	8.42 ± 0.51	20.09 ± 2.26	9.66 ± 2.56	12.38 ± 1.19
	7th day	70.26 ± 31.98	64.27 ± 8.09	30.16 ± 9.66	69 ± 3.01
	Month 1	79.74 ± 3.68	68.36 ± 6.29	52.16 ± 6.37	76.9 ± 3.1
	Month 3	75.71 ± 3.69	76.27 ± 5.61	58 ± 7.73	75.81 ± 2.92

Notes: Patients (n = 50) were classified to their graft functions and acute rejection episodes. Data are given as mean ± standard error. p-Values are given in the text. IGF: immediate graft function, SGF: slow graft function, AR: acute rejection, Pretx: pretransplant, GFR: glomerular filtration rate.

Table 3. Performance of serum creatinine, cystatin-C and TNFR2 for the determination of GFR changes at month 3.

Time	Parameters	Cutoff	AUC (CI: 95%)*	SH	Sensitivity	Specificity	LR+	LR−	p
Month 3	Creatinine	1.23	0.892 (0.786–0.997)	0.054	0.77	0.92	10.89	0.24	0.001
Month 3	Cystatin-C	1.38	0.817 (0.697–0.936)	0.061	0.66	0.85	4.67	0.39	0.001
Month 3	TNFR2	11.46	0.833 (0.711–0.956)	0.062	0.86	0.71	3.01	0.19	0.001

Notes: A cut-off level of eGFR was chosen as 60 mL/min. AUC (CI: 95%)* area under the curve with 95% confidence interval.

Table 4. Performance of serum creatinine, cystatin-C, TNF-α, TNFR1 and TNFR2 for the determination of acute rejection at day 7 and comparisons between TNF-α, TNFR1 and TNFR2 at month 1.

Period	Parameters	Cutoff	AUC (CI: 95%)*	SH	Sensitivity	Specificity	LR+	LR−	p
7th day	Creatinine	1.81	0.82 (0.52–1)	0.15	0.95	0.83	5.73	0.05	0.019
7th day	Cystatin-C	2.06	0.80 (0.50–1)	0.15	0.84	0.83	5.05	0.19	0.03
7th day	TNF-α	16.9	0.84 (0.70–0.98)	0.069	0.8	0.75	–	0.32	0.012
7th day	TNFR1	7.03	0.96 (0.90–1)	0.029	0.84	0.91	–	0.14	0.001
7th day	TNFR2	17.91	0.95 (0.87–1)	0.042	1	0.8	6	0	0.001
Month 1	TNF-α	14.72	0.75 (0.53–0.96)	0.11	0.88	0.66	2.66	0.17	0.049
Month 1	TNFR1	4.17	0.90 (0.80–0.99)	0.049	0.75	1	–	0.25	0.002
Month 1	TNFR2	11.9	0.91 (0.83–1)	0.043	0.81	1	–	0.18	0.001

Note: AUC (CI: 95%)* area under the curve with 95% confidence interval.