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Urinary K idney injury molecule‐1 can predict delayed graft function in living donor renal allograft recipients
Author(s) -
Yadav Brijesh,
Prasad Narayan,
Agrawal Vikas,
Jaiswal Akhilesh,
Agrawal Vinita,
Rai Mohit,
Sharma Raj,
Gupta Amit,
Bhadauria Dharmendra,
Kaul Anupama
Publication year - 2015
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.12511
Subject(s) - medicine , urinary system , creatinine , urology , receiver operating characteristic , renal transplant , renal function , area under the curve , urine , complication , transplantation
Aim Delayed graft function is an early complication leading to impaired creatinine clearance, urine formation and determinant of long term graft outcome. The aim of the present study was to determine the earliest predictive cut‐off value of uKIM ‐1 level in patients with delayed graft function and acute tubular necrosis. Methods We have determined the serial urinary KIM ‐1 normalized to urinary creatinine ( uKIM ‐1, pg/mg) level at 0, 6, 12, 18, 24 and 48 h of post‐transplant by ELISA methods. Result The normalized uKIM ‐1 and AUC‐ROC , of uKIM ‐1 were progressively increased up to 48 h in both delayed graft function ( DGF ) and immediate graft function ( IGF ). The u KIM ‐1 values were significantly high at 6, 12, 18, 24 and 48 h in patients with DGF as compared to that of IGF except at half an hour post‐transplant values. Although, progressive increase in uKIM ‐1 values were observed in both groups of patients; there was an overlap of values between two groups up to 12 h. The earliest non‐overlapping values of uKIM ‐1 between the groups were observed at 18 h onwards and minimum difference of 923.43 pg/mg. The earliest predictive AUC‐ROC of uKIM ‐1 in patients with DGF without overlap with IGF was also observed at 18 h post‐transplant with specificity of 100% and sensitivity of 89.9%. Conclusion Serial uKIM ‐1 measurement can be used as non‐invasive diagnostic biomarkers to predict the incident of DGF in living donor renal transplant recipients. At 18 th post‐transplant hour uKIM ‐1 can predict DGF with 100% specificity and 89.9% sensitivity with a cut‐off value of normalized KIM ‐1 of 923.43 pg/mg.