Urinary Tissue Inhibitor of Metalloproteinase and Insulin-like Growth Factor–7 as Early Biomarkers of Delayed Graft Function After Kidney Transplantation

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Abstract

Background Recently, urinary tissue inhibitor of metalloproteinase–2 (TIMP-2) and insulin-like growth factor–7 (IGFBP-7), markers for G1 cell cycle arrest, have been identified and validated in predicting the development of acute kidney injury in critically ill patients. It is unknown, however, whether these two biomarkers could predict the development of delayed graft function (DGF) after kidney transplantation (KT). Methods This is a single-center, prospective, observational study. We enrolled 74 patients who underwent KT between August 2013 and December 2016. Urine sample were collected immediately after the operation. The primary outcome was development of DGF as defined by need for dialysis of more than 1 session within 7 days of KT. Results Twenty-three patients (31%) were diagnosed with DGF. In univariate analysis, kidneys from expanded criteria donors, higher donor serum creatinine, lower donor estimated glomerular filtration rate, antithymoglobulin exposure, neutrophil gelatinase associated lipocalin, and urinary [TIMP-2]·[IGFBP7] were significantly different between early graft function and DGF. However, in multivariate analysis adjusting other factors, deceased donor and urinary [TIMP-2]·[IGFBP7] at 0 hours post-transplantation could predict the development of DGF. The receiver operating characteristic curve for prediction of DGF showed an area under the curve of 0.867 (sensitivity 0.86, specificity 0.71) for a cutoff value of 1.39. Conclusions Our results indicate that urine [TIMP-2]·[IGFBP7] immediately after transplantation could be an early, predictive biomarker of DGF in kidney transplantation.

Original languageEnglish
Pages (from-to)2050-2054
Number of pages5
JournalTransplantation Proceedings
Volume49
Issue number9
DOIs
Publication statusPublished - 2017 Nov 1

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Delayed Graft Function
Tissue Inhibitor of Metalloproteinases
Kidney Transplantation
Biomarkers
Insulin
Growth
Tissue Donors
Transplantation
Urine
G1 Phase Cell Cycle Checkpoints
Antilymphocyte Serum
Glomerular Filtration Rate
Acute Kidney Injury
Critical Illness
ROC Curve
Area Under Curve
Observational Studies
Dialysis
Creatinine
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

@article{567ec6e3cbf8461a954ac3a56c803aab,
title = "Urinary Tissue Inhibitor of Metalloproteinase and Insulin-like Growth Factor–7 as Early Biomarkers of Delayed Graft Function After Kidney Transplantation",
abstract = "Background Recently, urinary tissue inhibitor of metalloproteinase–2 (TIMP-2) and insulin-like growth factor–7 (IGFBP-7), markers for G1 cell cycle arrest, have been identified and validated in predicting the development of acute kidney injury in critically ill patients. It is unknown, however, whether these two biomarkers could predict the development of delayed graft function (DGF) after kidney transplantation (KT). Methods This is a single-center, prospective, observational study. We enrolled 74 patients who underwent KT between August 2013 and December 2016. Urine sample were collected immediately after the operation. The primary outcome was development of DGF as defined by need for dialysis of more than 1 session within 7 days of KT. Results Twenty-three patients (31{\%}) were diagnosed with DGF. In univariate analysis, kidneys from expanded criteria donors, higher donor serum creatinine, lower donor estimated glomerular filtration rate, antithymoglobulin exposure, neutrophil gelatinase associated lipocalin, and urinary [TIMP-2]·[IGFBP7] were significantly different between early graft function and DGF. However, in multivariate analysis adjusting other factors, deceased donor and urinary [TIMP-2]·[IGFBP7] at 0 hours post-transplantation could predict the development of DGF. The receiver operating characteristic curve for prediction of DGF showed an area under the curve of 0.867 (sensitivity 0.86, specificity 0.71) for a cutoff value of 1.39. Conclusions Our results indicate that urine [TIMP-2]·[IGFBP7] immediately after transplantation could be an early, predictive biomarker of DGF in kidney transplantation.",
author = "J. Yang and Lim, {S. Y.} and Myung-Gyu Kim and Jung, {Cheol Woong} and Cho, {Won Yong} and Jo, {Sang Kyung}",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.transproceed.2017.09.023",
language = "English",
volume = "49",
pages = "2050--2054",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Urinary Tissue Inhibitor of Metalloproteinase and Insulin-like Growth Factor–7 as Early Biomarkers of Delayed Graft Function After Kidney Transplantation

AU - Yang, J.

AU - Lim, S. Y.

AU - Kim, Myung-Gyu

AU - Jung, Cheol Woong

AU - Cho, Won Yong

AU - Jo, Sang Kyung

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background Recently, urinary tissue inhibitor of metalloproteinase–2 (TIMP-2) and insulin-like growth factor–7 (IGFBP-7), markers for G1 cell cycle arrest, have been identified and validated in predicting the development of acute kidney injury in critically ill patients. It is unknown, however, whether these two biomarkers could predict the development of delayed graft function (DGF) after kidney transplantation (KT). Methods This is a single-center, prospective, observational study. We enrolled 74 patients who underwent KT between August 2013 and December 2016. Urine sample were collected immediately after the operation. The primary outcome was development of DGF as defined by need for dialysis of more than 1 session within 7 days of KT. Results Twenty-three patients (31%) were diagnosed with DGF. In univariate analysis, kidneys from expanded criteria donors, higher donor serum creatinine, lower donor estimated glomerular filtration rate, antithymoglobulin exposure, neutrophil gelatinase associated lipocalin, and urinary [TIMP-2]·[IGFBP7] were significantly different between early graft function and DGF. However, in multivariate analysis adjusting other factors, deceased donor and urinary [TIMP-2]·[IGFBP7] at 0 hours post-transplantation could predict the development of DGF. The receiver operating characteristic curve for prediction of DGF showed an area under the curve of 0.867 (sensitivity 0.86, specificity 0.71) for a cutoff value of 1.39. Conclusions Our results indicate that urine [TIMP-2]·[IGFBP7] immediately after transplantation could be an early, predictive biomarker of DGF in kidney transplantation.

AB - Background Recently, urinary tissue inhibitor of metalloproteinase–2 (TIMP-2) and insulin-like growth factor–7 (IGFBP-7), markers for G1 cell cycle arrest, have been identified and validated in predicting the development of acute kidney injury in critically ill patients. It is unknown, however, whether these two biomarkers could predict the development of delayed graft function (DGF) after kidney transplantation (KT). Methods This is a single-center, prospective, observational study. We enrolled 74 patients who underwent KT between August 2013 and December 2016. Urine sample were collected immediately after the operation. The primary outcome was development of DGF as defined by need for dialysis of more than 1 session within 7 days of KT. Results Twenty-three patients (31%) were diagnosed with DGF. In univariate analysis, kidneys from expanded criteria donors, higher donor serum creatinine, lower donor estimated glomerular filtration rate, antithymoglobulin exposure, neutrophil gelatinase associated lipocalin, and urinary [TIMP-2]·[IGFBP7] were significantly different between early graft function and DGF. However, in multivariate analysis adjusting other factors, deceased donor and urinary [TIMP-2]·[IGFBP7] at 0 hours post-transplantation could predict the development of DGF. The receiver operating characteristic curve for prediction of DGF showed an area under the curve of 0.867 (sensitivity 0.86, specificity 0.71) for a cutoff value of 1.39. Conclusions Our results indicate that urine [TIMP-2]·[IGFBP7] immediately after transplantation could be an early, predictive biomarker of DGF in kidney transplantation.

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DO - 10.1016/j.transproceed.2017.09.023

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SP - 2050

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JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

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