대한신장학회

논문분류	춘계학술대회 초록집
제목	Urine Liver-type Fatty Acid-binding Protein (L-FABP) Predicts Graft Outcome Up to 2 Year after Kidney Transplantation
저자	Min Young Seo1, Hye Min Choi1, Cheol Woong Jung2, Kwan Tae Park2, Sang-Kyung Jo1,Wonyong Cho1, Hyoung Kyu Kim1, Myung-Gyu Kim1
출판정보	2013; 2013(1):
키워드	신장이식, 바이오마커, 만성 이식신 기능장애/Kidney transplantation, Biomarker, Chronic allograft nephropathy
초록	Background: In kidney transplant (KT) recipient, several new biomarkers have been investigated for predicting early tubular injury and our recent study identified day 2 urinary neutrophil gelatinase associated lipocalin (NGAL) to be useful in predicting slow graft function and adverse 1-year outcome. Here in this study, we further investigated the value of urinary NGAL and liver type fatty acid binding protein (L-FABP) in predicting long term graft outcome up to 2 years. Methods: This was a single-center, prospective observational study. Serial urinary NGAL and L-FABP levels at 0 hrs, 2 days and 6 days after KT were measured and the clinical outcomes including acute allograft rejection, proteinuria and estimated glomerular filtration rate (eGFR) were collected during the 2-year period after KT. Results: Of the 69 patients investigated, 14 and 7 experienced slow and delayed graft function (SGF and DGF), and urinary NGAL on day 2 after KT was significantly associated with SGF and DGF development, but L-FABP was not. During the 2-year follow up period, 13 (18.8%), 4 (5.8%) and 1 (1.4%) were diagnosed with acute T-cell mediated rejection, acute antibody mediated rejection (AMR) and chronic AMR, respectively. In addition, 10 (6.9%) developed calcineurin inhibitor toxicity and 6 (8.7%) developed BK viremia. The mean eGFRs at 1 and 2 years after KT were 65.1±19.1 and 58.5±22.6 ml/min/1.73m2. When poor long-term graft outcome was defined as eGFR at 2 year less than 50 mL/min/1.73 m2, elderly donor, AR and higher level of urinary L-FABP at 0hr were found to be significant risk factors. Furthermore, among the patients who did not develop AR, L-FABP showed more strong association with 2-year poor graft function (p=0.006). In the multivariate logistic regression analysis, higher L-FABP at 0 hr (p=0.015) as well as acute rejection (p=0.006) was also independent factor for predicting poor long-term graft function and ROC analysis showed that area under the curve (AUC) of urinary L-FABP was 0.692 (CI 0.509- 0.876, p=0.036). Conclusions: Our results demonstrate the possibility that urinary L-FABP might be useful in predicting adverse longterm outcome in KT patients.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정