ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-OR105

Galectin 3 and Graft Failure in Kidney Transplant Recipients: A 10-Year Prospective Cohort Study

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Sotomayor, Camilo G., University Medical Center Groningen, Groningen, Netherlands
  • te Velde - Keyzer, Charlotte A., University Medical Center Groningen, Groningen, Netherlands
  • van Londen, Marco, University Medical Center Groningen, Groningen, Netherlands
  • Gans, Reinold O.B., University Medical Center Groningen, Groningen, Netherlands
  • Nolte, Ilja M., University Medical Center Groningen, Groningen, Netherlands
  • De Borst, Martin H., University Medical Center Groningen, Groningen, Netherlands
  • Berger, Stefan P., University Medical Center Groningen, Groningen, Netherlands
  • Rodrigo, Ramon, University of Chile, Santiago, Chile
  • Bakker, Stephan J.L., University Medical Center Groningen, Groningen, Netherlands
Background

Galectin-3 is associated with kidney fibrosis and kidney function decline in the general population. We aimed to study the association of galectin-3 with long-term risk of graft failure in a cohort of extensively phenotyped kidney transplant recipients (KTR).

Methods

We performed a longitudinal cohort study in 561 KTR without heart failure and with a functioning graft ≥1 year. Kaplan-Meier curve, log-rank test, and multivariable-adjusted Cox proportional-hazards regression analyses were performed to assess the prospective association of baseline serum galectin-3 with death-censored graft failure (defined as restart of dialysis or re-transplantation). Subgroup prospective analyses were performed according to significant effect-modifiers.

Results

Median galectin-3 was 21.1 (IQR, 17.0-27.2) ng/mL. During a median follow-up of 9.5 (IQR, 6.2-10.2) years, 72 KTR developed graft failure, with significantly different distribution of events across tertiles of galectin-3 (P<0.001). In multivariable Cox regression analyses, galectin-3 associated with graft failure (HR, 2.13 per 1-SD increase; 95% CI, 1.61-2.80, P<0.001), independent of well-established general and transplant-specific risk factors, including eGFR and proteinuria. Particularly strong associations were found in patients with systolic blood pressure ≥140 mmHg (HR, 2.29 per 1-SD increase; 95% CI 1.80-2.92, P<0.001) and in former or current smokers (HR, 2.56 per 1-SD increase; 95% CI 1.95-3.37, P<0.001).

Conclusion

In stable KTR, galectin-3 levels are elevated and independently associated with higher risk of graft failure at 10-years of follow-up. These results underline novel opportunities to monitor patients, target pharmacological therapy, and decrease the burden of long-term graft failure in stable KTR.

Funding

  • Government Support - Non-U.S.