Urine NGAL and IL-18 are predictive biomarkers for delayed graft function following kidney transplantation
Urine NGAL and IL-18 are predictive biomarkers for delayed graft function following kidney transplantation
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DOI：
10.1111/j.1600-6143.2006.01352.x
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发表时间：
2006-07-01
影响因子：
8.8
通讯作者：
Devarajan, P.
中科院分区：
文献类型：
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作者：
Parikh, C. R.;Jani, A.;Devarajan, P.
由于小管细胞损伤导致的移植功能延迟（DGF）是死亡供肾移植的常见并发症。我们测试了尿中性粒细胞明胶酶相关脂钙蛋白（NGAL）和白细胞介素-18 （IL-18）是否代表DGF的早期生物标志物（定义为移植后第一周内的透析需求）。在第0天收集的活体供肾受体（n = 23）、具有即时移植功能的已故供肾（n = 20）和具有DGF的已故供肾（n = 10）的尿液样本，采用ELISA法对NGAL和IL-18进行双盲分析。在DGF患者中，需要透析的术后血清肌酐峰值通常发生在移植后2-4天。在第0天，三组的尿液NGAL和IL-18值有显著差异，其中DGF组的水平升高最大（p < 0.0001）。根据第0天尿液NGAL或IL-18预测DGF的受体工作特征曲线显示，这两种生物标志物的曲线下面积为0.9。多因素分析显示，在调整年龄、性别、种族、尿量和冷缺血时间的影响后，第0天尿NGAL和IL-18均能预测移植后血清肌酐的变化趋势（p < 0.01）。我们的研究结果表明，尿液NGAL和IL-18是DGF的早期预测性生物标志物。
Delayed graft function (DGF) due to tubule cell injury frequently complicates deceased donor kidney transplants. We tested whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) represent early biomarkers for DGF (defined as dialysis requirement within the first week after transplantation). Urine samples collected on day 0 from recipients of living donor kidneys (n = 23), deceased donor kidneys with prompt graft function (n = 20) and deceased donor kidneys with DGF (n = 10) were analyzed in a double blind fashion by ELISA for NGAL and IL-18. In patients with DGF, peak postoperative serum creatinine requiring dialysis typically occurred 2-4 days after transplant. Urine NGAL and IL-18 values were significantly different in the three groups on day 0, with maximally elevated levels noted in the DGF group (p < 0.0001). The receiver-operating characteristic curve for prediction of DGF based on urine NGAL or IL-18 at day 0 showed an area under the curve of 0.9 for both biomarkers. By multivariate analysis, both urine NGAL and IL-18 on day 0 predicted the trend in serum creatinine in the posttransplant period after adjusting for effects of age, gender, race, urine output and cold ischemia time (p < 0.01). Our results indicate that urine NGAL and IL-18 represent early, predictive biomarkers of DGF.