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Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Nephrol 2016 ; 43 (6): 454-9 Nephropedia Template TP
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Tubulointerstitial fibrosis of living donor kidneys associates with urinary monocyte chemoattractant protein 1 #MMPMID27288357
Wang X; Lieske JC; Alexander MP; Jayachandran M; Denic A; Mathew J; Lerman LO; Kremers WK; Larson JJ; Rule AD
Am J Nephrol 2016[]; 43 (6): 454-9 PMID27288357show ga
Background: Non-invasive biomarkers that detect occult pathology in patients with normal glomerular filtration rate (GFR) and normal urine albumin excretion may help identify patients at risk for chronic kidney diseases. Methods: Two promising biomarkers of interstitial fibrosis, urinary monocyte chemoattractant protein 1 (MCP-1) and collagen IV, were assayed among 634 living kidney donors from 2005 to 2011, who had both a frozen pre-donation spot urine sample and a core needle biopsy of their donated kidney at transplantation (?time zero biopsy?). The association of urine MCP-1 and collagen IV with kidney function (GFR and urine albumin excretion), kidney volume on computed tomographic imaging, and histological findings was assessed. Results: The mean ±SD age was 45±12 years, 24-h urine albumin was 4±7mg, and measured GFR (mGFR) was 102 ± 18 ml/min/1.73 m2. The median (25%, 75%) urine level of MCP-1 was 146 (54, 258) pg/ml, and of collagen IV was 2.0(1.0, 3.5) ug/L. Higher urine MCP-1 associated with higher 24-h urine albumin excretion; higher urine collagen IV associated with male gender. On kidney biopsy, any interstitial fibrosis was present in 22% and fibrosis > 5% in 4% of donors. The mean MCP-1/Cr ratio was 1.49 pg/mg for 0% fibrosis, 1.80 pg/mg for 1?5% fibrosis, 2.33 pg/mg for 6?10% fibrosis, and 4.33 pg/mg for > 10% fibrosis. After adjustment for age, sex, mGFR and 24-h urine albumin, higher urine MCP-1 but not collagen IV associated with interstitial fibrosis and tubular atrophy. Conclusion: Urine MCP-1 may detect early tubulointerstitial fibrosis in adults with normal kidney function.