Deceased Kidney Donor Biomarkers: Relationship between Delayed Kidney Function and Graft Function Three Years after Transplantation

Rima Maslauskiene; Ruta Vaiciuniene; Peteris Tretjakovs; Gita Gersone; Aurelija Radzeviciene; Andrejus Bura; Edgaras Stankevicius; Inga Arune Bumblyte

doi:10.3390/diagnostics14070717

Deceased Kidney Donor Biomarkers: Relationship between Delayed Kidney Function and Graft Function Three Years after Transplantation

Diagnostics (Basel). 2024 Mar 28;14(7):717. doi: 10.3390/diagnostics14070717.

Authors

Rima Maslauskiene¹, Ruta Vaiciuniene¹, Peteris Tretjakovs², Gita Gersone², Aurelija Radzeviciene³, Andrejus Bura¹, Edgaras Stankevicius³, Inga Arune Bumblyte¹

Affiliations

¹ Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
² Department of Human Physiology and Biochemistry, Riga Stradins University, Dzirciema Str. 16, LV-1007 Riga, Latvia.
³ Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 9, LT-44307 Kaunas, Lithuania.

Abstract

With an increasing number of marginal donors, additional methods for the evaluation of cadaveric kidney quality are required. This study aimed to evaluate pretransplant deceased donor serum (s) and urine (u) biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18, and C-X-C motif chemokine 10 (CXCL10) for predicting early and late graft function. In total, 43 deceased kidney donors and 76 corresponding recipients were enrolled. Delayed graft function (DGF) occurred in 27.6% of cases. sIL-18, sKIM-1, uNGAL, and uKIM-1 were predictors of DGF. A model incorporating sIL-18, uKIM-1, and clinical factors was developed to predict DGF (AUROC 0.863). Univariate analysis showed a negative association between uKIM and graft eGFR at 6, 12, 24, and 36 months, but this was not confirmed in the multivariate analysis. In conclusion, we report a superior performance of donor biomarkers for predicting DGF and later graft function over serum creatinine. Higher levels of donor sIL-18 and uKIM in conjunction with expanded-criteria donors and longer cold ischemia times predicted DGF. With no renal tubular damage in zero-time donor biopsies, higher pretransplant urine and serum NGAL levels were associated with better allograft function one year after transplantation, and sNGAL with graft function three years after transplantation.

Keywords: CXCL10; IL-18; KIM-1; NGAL; donor biomarker; kidney transplantation.

Grants and funding

This research was supported by the grant from the Research Council of Lithuania (No. P-MIP-17-445). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.