Early urinary CCL2 is associated with the later development of interstitial fibrosis and tubular atrophy in renal allografts
| Autor: | Leroy Storsley, David N. Rush, William P. Stefura, Kent T. HayGlass, Peter Nickerson, Ian W. Gibson, Jennifer Bestland, Martin Karpinski, Julie Ho |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Urinary system Urology Chemokine CXCL9 Atrophy Risk Factors medicine Humans Risk factor Prospective cohort study Chemokine CCL2 Transplantation Kidney Univariate analysis Analysis of Variance business.industry Odds ratio Middle Aged medicine.disease Kidney Transplantation Surgery Chemokine CXCL10 medicine.anatomical_structure Kidney Tubules Nephritis Interstitial Female Kidney Diseases business Biomarkers Follow-Up Studies |
| Zdroj: | Transplantation. 90(4) |
| ISSN: | 1534-6080 |
| Popis: | Background Chronic renal allograft injury resulting in progressive interstitial fibrosis and tubular atrophy (IFTA) is a leading cause of graft loss. The goal of this study was to identify early urinary predictors for the subsequent development of IFTA in a prospective cohort of patients (n=111) who underwent serial protocol biopsies at 0, 6, and 24 months. Methods The urinary proteins evaluated were CCL2, CXCL9, CXCL10, and alpha1-microglobulin (alpha1M) using ELISA and immunonephelometry. Results We first evaluated urines obtained at 1 to 3 months and found that alpha1M and CXCL10 were associated with IFTA at 6 months but not at 24 months. Next, we evaluated urines at 6 months and found that CCL2 was associated with both IFTA and graft dysfunction at 24 months. On univariate analysis, 6-month urinary CCL2 was a risk factor for developing 24-month IFTA, defined as ci+ct score more than 0 (odds ratio 1.045, 95% confidence interval: 1.005-1.084, P=0.028). Furthermore, CCL2 remained an independent predictor of IFTA on multivariate analysis (odds ratio 1.049, 95% confidence interval: 1.006-1.094, P=0.024) when adjusted for donor age, delayed graft function, deceased donation, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker exposure. In comparison, alpha1M, CXCL9, and CXCL10 were not associated with late graft outcomes. Conclusion This study demonstrates that early urinary CCL2 is an independent predictor for the subsequent development of IFTA at 24 months. |
| Databáze: | OpenAIRE |
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