Urinary APOA4 as a Biomarker for Chronic Renal Allograft Injury and Rapid Renal Function Decline in Kidney Transplant Recipients
1Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea, Republic of, 2Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea, Republic of, 3Department of Surgery, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea, Republic of
Meeting: 2020 American Transplant Congress
Abstract number: D-257
Keywords: Kidney transplantation, Renal injury
Session Information
Session Name: Poster Session D: Biomarkers, Immune Assessment and Clinical Outcomes
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Chronic renal allograft injury (CRAI) remains a major cause of allograft loss in kidney transplant recipients (KTRs). The aim of this study was to identify urinary biomarkers associated with CRAI and rapid renal function decline in KTRs.
*Methods: This study included 30 KTRs whose estimated GFR was less than 60 mL/min/1.73m2 (CRAI group), and 20 KTRs with normal allograft function (control group). To identify potential urinary biomarkers, we performed SDS-PAGE followed by liquid chromatography-mass spectrometry (LC-MS/MS). Several urinary proteins including Apolipoprotein A4 (APOA4) were validated by ELISA. Rapid renal function decline was defined as estimated GFR decline of >3 mL/min/1.73m2/year or initiation of dialysis for 3 years after baseline sampling.
*Results: Among protein profiles identified by proteomics, urinary APOA4 levels were different between CRAI group and control group (15615.0 vs. 2447.9, P<0.001). Urinary APOA4 levels measured by ELISA were also higher in CRAI group (170914.0±166309.5 vs. 14187.5±19959.8 ng/mL, P<0.001). APOA4 levels had high association with CRAI group compared to control group (AUC 0.883 [0.794-0.973], P<0.001) in ROC curve. Among 50 KTRs, 19 patients (38%) were classified as rapid renal function decline group. Urinary APOA4 levels were higher in rapid renal function decline group than stable renal function group (215430.5±181781.3 vs. 42515.9±72438.4 ng/mL, P=0.001). Log-transformed APOA4 values predicted rapid renal function decline in KTRs (odds ratio 6.70 [95% CI 2.56-22.83]).
*Conclusions: These results suggest that urinary APOA4 level might be a potential biomarker for detection of CRAI and could be used as predictor for rapid renal function decline in KTRs.
To cite this abstract in AMA style:
Jeon H, Shin D, Oh J, Park J, Ko K, Kim J, Lee S. Urinary APOA4 as a Biomarker for Chronic Renal Allograft Injury and Rapid Renal Function Decline in Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/urinary-apoa4-as-a-biomarker-for-chronic-renal-allograft-injury-and-rapid-renal-function-decline-in-kidney-transplant-recipients/. Accessed July 15, 2025.« Back to 2020 American Transplant Congress