Iranian Journal of Pathology

Predictive Values of Urinary Interleukin 18 and Neutrophil Gelatinase-Associated Lipocalin for Delayed Graft Function Diagnosis in Kidney Transplantation

Document Type : Original Research

Authors

Mojtaba Mojtahedzadeh 1
Farhad Etezadi 2
Javad Motaharinia 1
Alireza Abdollahi 3
Abdorasul Mehrsai 4
Shadi Ziaie 5
Soheil Saadat 6

1 Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

2 Dept. of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Valiasr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

4 Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Faculty of Pharmacy, Shahid Beheshty University of Medical Sciences, Tehran, Iran

6 Trauma Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Background: Delayed graft function is a main complication after deceased donor kidney transplantation that adversely affects graft outcome. Difficulties in prediction and early detection of delayed graft function have hindered the ability to perform proper therapeutic interventions. We investigated whether measuring urinary interleukin 18 and neutrophil gelatinase-associated lipocalin as markers of ischemia reperfusion injury could predict delayed graft function in deceased donor kidney transplant patients.
Methods: We studied 69 patients undergoing kidney transplantation from deceased donor during early October 2013 to December 2014 at the Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Serial urine samples at 2, 24, and 48 h after transplantation were analyzed for interleukin 18 and neutrophil gelatinase-associated lipocalin levels.
Results: Thirteen patients (18.9%) developed delayed graft function. Urine interleukin 18 to urine creatinine ratio was significantly higher in patients with delayed graft function compared to those with non-delayed graft function, at 2 (P=0.003), 24 (P<0.001) and 48 h (P=0.018) points. The levels of neutrophil gelatinase-associated lipocalin to urine creatinine ratio were significantly higher in the group with delayed graft function at the 24 (P=0.004) and 48 h (P=0.015) points. The receiver–operating characteristic curve analysis suggested that both urinary biomarkers at 24 h after transplantation had better accuracies for prediction of delayed graft function. In multivariate analysis, only urinary interleukin 18 to urine creatinine ratio improved the ability of clinical model for predicting delayed graft function.
Conclusion: Urinary interleukin 18 to urine creatinine ratio at 24 h post-transplantation, along with traditional markers such as relative fall in serum creatinine, urine output and other risk factors for delayed graft function, increased the ability to predict delayed graft function.

Keywords

Kidney transplantation
Deceased donor
Delayed graft function
Interleukin 18
Neutrophil gelatinase-associated lipocalin

Subjects

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Iranian Journal of Pathology
Volume 11, Issue 4
Autumn 2016
Pages 391-398

  • Receive Date 12 October 2015
  • Revise Date 27 December 2015
  • Accept Date 23 February 2016

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