Urinary neutrophil gelatinase-associated lipocalin predicts graft loss after acute kidney injury in kidney transplant

Abstract

Objective: Establish the prognostic value for graft loss of urinary neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule-1 (uKIM-1), interleukin-18 (uIL-18), and heat shock protein 72 (uHsp72) in kidney transplant recipients (KTR) with acute kidney injury (AKI).

Methods: Biomarkers were measured in 67 KTR with AKI caused by different entities.

Results: After 1 year, 11 KTR with graft loss had higher uNGAL compared to KTR without loss (p < 0.001). There were no differences for uKIM-1, uIL-18 and uHsp-72. uNGAL >200 ng/mL had 84% sensitivity and 86% specificity for graft loss (ROC AUC: 0.89, 95% CI: 0.81–0.97). uNGAL may be useful to predict graft loss after AKI.

• Acute kidney injury
• allograft failure
• graft loss
• NGAL
• sensitivity and specificity
• urinary biomarkers

Acknowledgements

We are grateful to Rosalba Pérez for her technical assistance. The results presented in this article have not been published previously in whole or in part, except as an abstract presented at Kidney Week 2012: 45th Annual Meeting (San Diego, CA). J.C.R.S., R.C.R., N.A.B., L.E.M.B. conceived and design the study; J.C.R.S., J.B.C., P.E.S., A.R.M. included patients and 1 year follow-up; J.C.R.S., J.B.C., A.R.M., R.C.R., N.A.B., L.E.M.B. analyzed the data; J.B.C., P.E.S., N.A.B. contributed reagents or analysis tools; J.C.R.S., J.B.C., N.A.B., R.C.R., L.E.M.B. wrote the article.