High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients.

@article{citeulike:2463201, abstract = {BACKGROUND: Chronic transplant dysfunction is characterized by renal function decline and proteinuria. Kidney injury molecule (KIM)-1, a transmembrane tubular protein with unknown function, is undetectable in normal kidneys, but markedly induced after injury. Urinary KIM-1 excretion has been quantified as biomarker of renal damage. We prospectively studied whether urinary KIM-1 predicts graft loss, independent of renal function and proteinuria. METHODS: Renal transplant recipients (n=145) visiting our outpatient clinic between August 2001 and July 2003 collected 24-hour urine samples for assessment of baseline urinary KIM-1 excretion (microsphere-based Luminex technology), and were followed for graft loss. RESULTS: Recipients participated at a median (interquartile range) of 6.0 (2.5-12.0) years posttransplant in baseline measurements. Follow-up beyond baseline was 4.0 (3.2-4.5) years. Urinary KIM-1 excretion was 0.72 (0.42-1.37) ng per 24 hours. Occurrence of graft loss increased over tertiles of KIM-1 excretion: 3 (6.3\%), 11 (22.4\%), and 17 cases (35.4\%; P=0.001), respectively. High KIM-1 excretion was associated with proteinuria, low creatinine clearance, and high donor age (all P<0.01). In multivariate Cox regression analyses, prediction of graft loss by KIM-1 appeared independent of creatinine clearance, proteinuria, and donor age. Hazard ratios (95\% CI) for the second and third tertile of KIM-1 excretion were 3.6 (0.9-13.5) and 5.1 (1.5-17.8) in the final model. CONCLUSIONS: Urinary excretion of KIM-1 is an independent predictor of long-term graft loss and therefore a promising new biomarker in early prediction of graft loss.}, address = {Department of Pathology and Laboratory Medicine, University Medical Center Groningen and University of Groningen, the Netherlands. m.m.van.timmeren@path.umcg.nl}, author = {van Timmeren, M. M. and Vaidya, V. S. and van Ree, R. M. and Oterdoom, L. H. and de Vries, A. P. and Gans, R. O. and van Goor, H. and Stegeman, C. A. and Bonventre, J. V. and Bakker, S. J. }, citeulike-article-id = {2463201}, doi = {http://dx.doi.org/10.1097/01.tp.0000295982.78039.ef}, issn = {0041-1337}, journal = {Transplantation}, month = {December}, number = {12}, pages = {1625--1630}, posted-at = {2008-03-04 05:15:03}, priority = {2}, title = {High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients.}, url = {http://dx.doi.org/10.1097/01.tp.0000295982.78039.ef}, volume = {84}, year = {2007} }

TY - JOUR ID - citeulike:2463201 L3 - citeulike-article-id:2463201 TI - High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients. JF - Transplantation VL - 84 IS - 12 SP - 1625 EP - 1630 AD - Department of Pathology and Laboratory Medicine, University Medical Center Groningen and University of Groningen, the Netherlands. m.m.van.timmeren@path.umcg.nl SN - 0041-1337 N2 - BACKGROUND: Chronic transplant dysfunction is characterized by renal function decline and proteinuria. Kidney injury molecule (KIM)-1, a transmembrane tubular protein with unknown function, is undetectable in normal kidneys, but markedly induced after injury. Urinary KIM-1 excretion has been quantified as biomarker of renal damage. We prospectively studied whether urinary KIM-1 predicts graft loss, independent of renal function and proteinuria. METHODS: Renal transplant recipients (n=145) visiting our outpatient clinic between August 2001 and July 2003 collected 24-hour urine samples for assessment of baseline urinary KIM-1 excretion (microsphere-based Luminex technology), and were followed for graft loss. RESULTS: Recipients participated at a median (interquartile range) of 6.0 (2.5-12.0) years posttransplant in baseline measurements. Follow-up beyond baseline was 4.0 (3.2-4.5) years. Urinary KIM-1 excretion was 0.72 (0.42-1.37) ng per 24 hours. Occurrence of graft loss increased over tertiles of KIM-1 excretion: 3 (6.3%), 11 (22.4%), and 17 cases (35.4%; P=0.001), respectively. High KIM-1 excretion was associated with proteinuria, low creatinine clearance, and high donor age (all P<0.01). In multivariate Cox regression analyses, prediction of graft loss by KIM-1 appeared independent of creatinine clearance, proteinuria, and donor age. Hazard ratios (95% CI) for the second and third tertile of KIM-1 excretion were 3.6 (0.9-13.5) and 5.1 (1.5-17.8) in the final model. CONCLUSIONS: Urinary excretion of KIM-1 is an independent predictor of long-term graft loss and therefore a promising new biomarker in early prediction of graft loss. AU - van Timmeren, MM AU - Vaidya, VS AU - van Ree, RM AU - Oterdoom, LH AU - de Vries, AP AU - Gans, RO AU - van Goor, H AU - Stegeman, CA AU - Bonventre, JV AU - Bakker, SJ PY - 2007/12/27/ UR - http://dx.doi.org/10.1097/01.tp.0000295982.78039.ef ER -