Serum neutrophil gelatinase-associated lipocalin and interleukin-18 as predictive biomarkers for delayed graft function after kidney transplantation.
BACKGROUND
Early biomarkers for acute kidney injury after kidney transplantation have been studied because delayed graft function (DGF) is associated with increased risk of acute rejection and graft loss. We investigated the usefulness of serum neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) for the prediction of DGF after kidney transplantation.


METHODS
Fifty-nine kidney transplant recipients were included and they were separated into DGF and immediate graft function (IGF) groups. Serum samples were collected on the preoperative day as well as days 1, 5, and 14 after the transplantation, and assayed for NGAL and IL-18.


RESULTS
After transplantation, serum levels of NGAL were significantly higher at any time in patients with DGF compared to those with IGF. Serum concentrations of IL-18 were not different between both groups. The receiver operating characteristics(ROC)-area under the curve (AUC) values of NGAL, IL-18, and creatinine on day 1 for the discrimination of DGF from IGF were 0.86, 0.63, and 0.65. On POD1, the sensitivities of NGAL and creatinine were respectively 78.6%, and 50.0% at 77.8% specificity, and the AUC values for any combinations including NGAL and that for NGAL alone were higher than that of creatinine.


CONCLUSIONS
Serum NGAL is an early and sensitive marker of graft dysfunction in kidney transplantation, while serum IL-18 showed limited values.
Department of Laboratory Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, Korea.
Eun Young
EY
Lee
Myoung Soo
MS
Kim
Yongjung
Y
Park
Hyon-Suk
HS
Kim
D000209:Acute-Phase Proteins; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood / Q000652:urine; D051799:Delayed Graft Function / Q000097:blood*; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D016030:Kidney Transplantation; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies
D000209:Acute-Phase Proteins; D015415:Biomarkers; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine