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Tubular urinary biomarkers do not identify aetiology of acute kidney injury in kidney transplant recipients
Author(s) -
RamirezSandoval Juan C,
BarreraChimal Jonatan,
Simancas Perla E,
CorreaRotter Ricardo,
Bobadilla Norma A,
MoralesBuenrostro Luis E
Publication year - 2014
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12240
Subject(s) - medicine , acute kidney injury , urinary system , kidney , lipocalin , creatinine , rifle , kidney transplantation , receiver operating characteristic , urology , gastroenterology , archaeology , history
Aim To evaluate the performance of urinary neutrophil gelatinase‐associated lipocalin (uNGAL), kidney injury molecule, interleukin‐18 and heat shock protein 72 for differential diagnosis between causes of acute kidney injury in kidney transplant recipients, especially immunological rejection. Patients and Methods We measured these biomarkers in 67 kidney transplant recipients with acute kidney injury according to the RIFLE criteria. Results There were no statistical differences in biomarkers between kidney transplant recipients with immunological rejection ( n = 20), pre‐renal causes ( n = 20) and other AKI causes ( n = 27). Only the uNGAL level relative to urinary creatinine (uNGAL/uCr) for immunological rejection was different in comparison with others ( P < 0.001); a cut‐off of 59 μg/g of uNGAL/uCr had a sensitivity and specificity of 60% and 58% respectively (area under the curve in receiver‐operating characteristic curve, 0.65). The other biomarkers were not useful in differentiating the causes of acute kidney injury. Conclusion The biomarkers tested are not useful in identifying immunological rejection as cause of acute kidney injury in kidney transplant recipients.