Abstract: TH-PO1103
Plasma Neutrophil Gelatinase Associated Lipocalin (NGAL) Predicts Long-Term Graft Survival in Stable Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Predictors of Outcomes - Biomarkers and Beyond
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Hinz, Ricarda Merle, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Swolinsky, Jutta Sybille, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Markus, Carolin Elfriede, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Singer, Eugenia, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Gebert, Pimrapat, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Budde, Klemens, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Eckardt, Kai-Uwe, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Westhoff, Timm H., Ruhr-University Bochum, Germany, Herne, Germany
- Schmidt-Ott, Kai M., Charité-Universitätsmedizin Berlin, Berlin, Germany
Group or Team Name
- AG Schmidt-Ott
Background
Neutrophil gelatinase-associated lipocalin (NGAL) has been evaluated as a biomarker of acute tubular injury in the kidney. The utility of NGAL to predict long-term outcomes in stable kidney transplant recipients (KTR) is unknown.
Methods
We conducted a monocentric, prospective observational study enrolling 709 stable KTR more than two months after renal transplantation. Baseline characteristics, standard laboratory values, and plasma NGAL (pNGAL) levels were determined at the time of inclusion. Patients were followed up for death-censored graft loss, defined by a continued requirement for renal replacement therapy. The utility of pNGAL levels to predict graft loss was evaluated by Receiver Operating Characteristics (ROC) analyses, Cox regression as well as competing risk analyses and Kaplan-Meier estimates.
Results
During a median follow-up of 58 months, death-censored graft loss occurred in 49 patients. The median pNGAL within the entire cohort was 189 [IQR 130-257] ng/ml. Patients who later experienced graft loss had a pNGAL of 304 [IQR 234.5-358] ng/ml (p<0.001). Time-dependent ROC analyses indicated an Area-Under-the-Curve value for pNGAL of 0.795 to predict graft loss within 5 years. pNGAL >230ng/ml had a sensitivity of 0.82 and a specificity of 0.71. Multivariate Cox regression analyses as well as competing risk analyses showed that pNGAL was an independent predictor of graft loss after adjustment for clinical parameters and kidney function. Patients with serum creatinine (sCrea) values ≥ 1.75mg/dl and pNGAL ≥ 230ng/ml had an approximately 9-fold higher risk of graft loss compared with patients with sCrea ≥ 1.75mg/dl and pNGAL < 230ng/ml. (p<0.001).
Conclusion
pNGAL levels in stable KTR may help to predict long-term graft survival.