Urinary Retinol-Binding Protein 4 is Associated With Renal Function and Rapid Renal Function Decline in Kidney Transplant Recipients |
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| Affiliation: | 1. Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;2. Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;3. Department of Surgery, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;4. Department of Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea;1. Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;2. Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;1. Nuclear Medicine Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia;2. Nuclear Medicine Department, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia;3. Nephrology Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia;1. Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan;2. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan;1. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea;2. Keimyung University Kidney Institute, Daegu, Korea;1. Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;2. Transplant Center, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;3. Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;4. Division of Transplant Surgery, Tokyo Metropolitan Health and Hospitals Corporation Ohkubo Hospital, Shinjuku Ward, Tokyo, Japan;5. Department of Nephrology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan |
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| Abstract: | ![]()
BackgroundUrinary retinol-binding protein 4 (RBP4) has been known as a biomarker of chronic kidney disease. In this study, we evaluated the association of urinary RBP4 with renal function and progression of renal function in kidney transplant recipients (KTRs).MethodsA total 50 KTRs were included in this study. Proteomic analysis with liquid chromatography-mass spectrometry and tandem mass spectrometry was performed to discover potential urinary biomarkers. Several urinary proteins including RBP4 were identified and then validated by enzyme-linked immunosorbent assay. Rapid renal function decline was defined as estimated glomerular filtration rate (eGFR) decline of >3 mL/min/1.73 m2/year or initiation of dialysis, and 19 (38%) were included in rapid renal function decline group.ResultsUrinary RBP4/creatinine was inversely correlated with allograft function (r = –0.54, P < .001 with eGFR, and r = 0.49, P < .001 with serum creatinine, respectively). Urinary RBP4/creatinine was higher in rapid renal function decline group than in stable renal function group (184.9 ± 156.7 vs 83.1 ± 99.9, P = .017). Log-transformed urinary RBP4/creatinine was significantly associated with rapid renal function decline in univariate logistic regression analysis (Odds ratio [OR] 7.59, confidence interval [CI] 2.04-36.70, P = .005). In multivariate logistic regression adjusted with recipient age and sex, donor age, number of HLA mismatch, and acute rejection episode, urinary RBP4/creatinine remained a significant factor for rapid renal function decline (OR 9.43, CI 1.99-65.65, P = .010). Receiver operating characteristic analysis showed that the area under the curve of urinary RBP4/creatinine was 0.747 (CI 0.608-0.886, P < .001) for rapid renal function decline.ConclusionsUrinary RBP4 levels are associated with renal function and might be used to predict rapid renal function decline in KTRs. |
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