Background and aims: Chronic kidney disease (CKD) is a common complication after liver transplantation. Kidney biopsies cannot be easily performed before liver transplantation to predict patients at high risk for CKD. The aim of our study was to determine whether peptides present in pre-liver transplant urine samples were associated with loss in kidney function at 6 months post-transplantation using proteome analysis.

Methods: Eighty patients who underwent a liver transplantation and that had pre-transplant glomerular filtration rate (GFR) value of ≥60 mL/min/1.73 m² (MDRD) were included in the study. For peptidome analysis, urine samples were collected before transplantation.

Results: GFR decreased significantly after transplantation. At month 6 post-transplantation, 40 patients displayed a CKD, i.e. eGFR of <60 mL/min/1.73 m², while the other 40 patients did not. Although thousands of peptides were identified, none was significantly associated with the development of CKD at 6 months after liver transplantation. Moreover, using a urinary peptidome classifier to detect preexisting CKD, no difference was found in CKD scores between the 2 groups. After analysis of a large number of pre-, peri- and post-transplant parameters, viral hepatitis as a cause for liver transplantation was the sole independent predictive factor for CKD. No difference in peptides with differential urinary abundance between patients who received a graft for virus related liver disease versus all other causes of liver disease was observed.

Conclusion: Peptidome analysis of urine before liver transplantation failed to identify a peptide pattern associated with the development of CKD after liver transplantation.

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