Can we Use Donor and Recipient Neutrophil Gelatinase-Associated Lipocalin (NGAL) to Predict Graft Function

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Abstract

Background

Neutrophil gelatinase-associated lipocalin (NGAL) is a protein belonging to the lipocalin superfamily initially found in activated neutrophils. NGAL levels predict the future appearance of acute kidney injury after treatments potentially detrimental to the kidney and even the acute worsening of unstable nephropathies. Furthermore, recent evidence also suggests that NGAL somehow may be involved in the pathophysiological process of chronic renal diseases. NGAL levels correlate with severity of renal impairment, probably expressing the degree of active damage underlying the chronic condition. The key advantage of NGAL is that it grows in plasma earlier than others renal function markers. The study was carried out in order to assess the utility of plasma NGAL in both kidney transplant (KTx) recipients and KTx donors to predict the function of the kidney transplant.

Methods

Study population comprised 66 KTx recipients and 38 kidney donors. The biochemical parameters, serum creatinine and plasma concentration of NGAL were obtained from donor before organ harvesting and from recipients before transplantation (day 0) and all measurements were repeated after 1, 2, 7, 14, 30 days and 1month, 3 month, 6 month and 1 year after transplantation. Donor renal function was evaluated before organ donation procedure, for assessing the donor kidney function and prediction results of transplantation we used NGAL, creatynine.

Results

1/ There’s a significant positive relation between dNGAL and dCr.

Results

2/ Spearman’s correlation between dNGAL vs. rNGAL are not significant p>0,082.

Results

3/ dNGAL does not correlate with rCr p>0,3.

Results

4/ANOVA analysis shows that NGAL1, 2 can significantly predicts ATN (p<0,0001)

Results

5/ NGAL 0 to 1 year cannot significantly predict whether AR appears (p>0,94). Only NGAL 7 can significantly predict AR.

Conclusion

Plasma rNGAL1,2 level seems to be reliable to predict ATN in the kidney transplant function. Only NGAL 7 may reliable predict an early AR. However dNGAL concentration does not predict the function of the kidney transplant.

Key words

renal transplantion, serum creatinine, neutrophil gelatinase-associated lipocalin

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