The aetiology of renal transplant dysfunction is varied, and diagnosis often relies upon transplant biopsy, an invasive procedure that carries significant risk. Availability of a reliable, non-invasive test to determine the cause of graft dysfunction and facilitate longitudinal monitoring of an individual patient is therefore of significant clinical interest.

Recent studies have shown that levels of urinary chemokines may distinguish causes of allograft dysfunction, and, furthermore, correlate with long-term graft function. We have previously shown that urinary levels of osteoprotegerin (OPG), monokine induced by interferon-γ (MIG) and interferon-induced protein-10 (IP-10) were significantly higher in patients with acute rejection compared to controls. In this study, we extended this analysis to renal transplant patients with quiescent graft function or allograft dysfunction, including patients with ATN, rejection, BKV infection and those with an index of chronic damage (ICD) >20%.

360 urine samples were collected prospectively from 133 patients undergoing a protocol or clinically indicated biopsy, including 27 patients with rejection, 7 with BK viraemia/viruria, 18 with ATN, 27 with ICD >20% and 54 controls. Samples were analysed in duplicate using the Life Technologies™ Invitrogen™ Plexmark® 3 Renal Biomarker Panel kit.

As shown in Table 1, there were significant differences in the mean levels of IP-10, OPG & MIG between groups. There were also significant differences in each of the chemokines when pairwise comparisons were made according to diagnoses, particularly when comparing controls to those with rejection or BKV infection. There were no significant differences in the levels of any chemokine when patients with rejection were compared to those with BKV infection, but it was possible to distinguish patients with ATN or an ICD >20%.

These data support accumulating evidence that urinary biomarkers are a useful, non-invasive tool in the diagnosis of graft dysfunction.

CITATION INFORMATION: Chong S, Fernando R, Harber M, Magee C. The Role of Urinary Chemokines in Distinguishing Causes of Renal Allograft Dysfunction. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress