The MYH9 gene was identified as a susceptibility locus associated with diminished filtration rate in the course of chronic nephropathies: primary focal segmental glomerulosclerosis (FSGS), lupus nephritis, IgA nephropathy. Nevertheless, there is no data regarding its impact on the kidney allograft function.

In the prospective cohort study performed in 296 deceased donor kidney recipients (transplantation between 2007 and 2012) eight SNPs previously shown to be associated with kidneys function (rs4821480, rs4821481, rs2032487, rs3752462, rs11089788, rs5756168, and rs2239784) were genotyped.

Minor allelic variant of rs5756168 (NC_000022.11:g.36378767T>C) was associated with increased incidence of FSGS as a primary disease: 9.5% (4/42) in allele C carriers and 2.5% (7/248) in TT homozygotes (p<0.058), as well as excessive risk of delayed graft function (p<0.010).

Kidneys from donors with TT genotype were prone to moderately diminished but stable eGFR (p<0.012) with excessive risk for proteinuria since sixth post-transplant months (OR 1.91 95%CI: 1.00-3.64; p<0.050). Recipients carrying two T alleles experienced higher eGFR starting from the sixth post-transplant month (p<0.038) and their risk of proteinuria was halved until third (p<0.010) and after sixth (p<0.044) post-transplant months.

There was a complex interplay between donor and recipient rs5756168 genotypes that resulted in eGFR stratification. Allele C carriers, who received a kidney transplant also carrying an allele C experienced significantly diminished filtration rate which persisted over 4 years of observation (p<0.008). Genotyping for MYH9 may be useful in identifying patients and organs of excessive risk for graft dysfunction.

The study was supported by grant from the National Science Centre N N402 5668 40.

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