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- Title
Urinary Post-Translationally Modified Fetuin-A Protein Is Associated with Increased Risk of Graft Failure in Kidney Transplant Recipients.
- Authors
Alkaff, Firas F.; Kremer, Daan; te Velde-Keyzer, Charlotte A.; van den Born, Jacob; Berger, Stefan P.; Laverman, Gozewijn D.; Chuang, Lee-Ming; Tseng, Tzu-Ling; Bakker, Stephan J.L.
- Abstract
Introduction: Urinary fetuin-A has been identified as a biomarker for acute kidney injury and is proposed as a biomarker for early detection of kidney function decline. We investigated whether fetuin-A could serve as a marker of graft failure in kidney transplant recipients (KTRs). Methods: Data of KTR with a functioning graft ≥1 year that were enrolled in the TransplantLines Food and Nutrition Biobank and cohort study were used. Graft failure was defined as the need for re-transplantation or (re-)initiation of dialysis. Urinary fetuin-A was measured using an enzyme-linked immunosorbent assay kit that detected post-translationally modified fetuin-A in the urine (uPTM-FetA). In the main analyses, 24h uPTM-FetA excretion was used. In the sensitivity analyses, we excluded the outliers in 24h uPTM-FetA excretion, and we used uPTM-FetA concentration and uPTM-FetA concentration indexed for creatinine instead of 24h uPTM-FetA excretion. Results: A total of 627 KTRs (age 53 ± 13 years, 42% females) were included at 5.3 (1.9–12.2) years after transplantation. The estimated glomerular filtration rate (eGFR) was 52 ± 20 mL/min/1.73 m2 and uPTM-FetA excretion was 34 (17–74) µg/24 h. During a median follow-up of 5.3 (4.5–6.0) years after baseline measurements, 73 (12%) KTRs developed graft failure. The association of 24h uPTM-FetA excretion with increased risk of graft failure was not constant over time, with increased risk only observed after 3 years from baseline measurements, independent of potential confounders including kidney function and 24 h urinary protein excretion (hazard ratio per doubling of 24h uPTM-FetA excretion = 1.31; 95% confidence interval = 1.06–1.61). This finding was robust in the sensitivity analyses. Conclusions: Our findings suggest that uPTM-FetA can be used as a marker for early detection of graft failure in KTR. Further studies are needed to confirm our findings.
- Subjects
KIDNEY transplantation; KIDNEY failure; KIDNEY physiology; ACUTE kidney failure; ENZYME-linked immunosorbent assay
- Publication
American Journal of Nephrology, 2024, Vol 55, Issue 2, p225
- ISSN
0250-8095
- Publication type
Article
- DOI
10.1159/000534829