title: Pre-transplant angiotensin II type 1receptor antibodies: a risk factor for decreased kidney graft function in the early post-transplant period?
abstract: Angiotensin II type 1 receptor antibodies (AT1Rab) are associated to a significantly lower graft survival and a higher risk of acute rejection after kidney transplantation. This study aimed to evaluate graft function and BPAR during the 1st year post-transplant (PT) in adult kidney transplant recipients (KTR), between 03/2009 and 08/2012. Pre-KT sera were screened for AT1Rab (ELISA) and HLA-DSA (Luminex). Three groups were analyzed: AT1Rab only (n = 13); HLA-DSA only (n = 8); and no AT1Rab or HLA-DSA (n = 90). No differences were observed in clinical characteristics across groups. A higher percentage of BPAR was observed in the AT1Rab positive group, but this difference was not significant. KTR with AT1Rab had a lower mean eGFR (20 mL/min/1.73m2) when compared to KTR with no Abs at 12 months. The significant difference in eGFR was observed since the 1st month PT. Multivariate analysis showed 4 factors independently and significantly associated with eGFR at 12mos PT: BPAR (-18.7 95%, CI -28.2 to -9.26, p<0.001), AT1Rab (-10.51, CI -20.9 to -0.095, p = 0.048), donor age (-0.42, CI -0.75 to -0.103 p = 0.010), and recipient age (-0.36, CI -0.67 to -0.048, p = 0.024). In this study AT1Rab in pre-transplant sera from KTR, was an independent and significant risk factor contributing to a lower eGFR 12 months. PT. This finding deserves to be confirmed in a larger KTR population.
authors.forename: Erick Alejandro
authors.initials: EA
authors.lastname: Hernández-Méndez
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Arreola-Guerra
authors.forename: Luis E
authors.initials: LE
authors.lastname: Morales-Buenrostro
authors.forename: Julia B
authors.initials: JB
authors.lastname: Ramírez
authors.forename: Said
authors.initials: S
authors.lastname: Calleja
authors.forename: Natalia
authors.initials: N
authors.lastname: Castelán
authors.forename: Isaac
authors.initials: I
authors.lastname: Salcedo
authors.forename: Mario
authors.initials: M
authors.lastname: Vilatobá
authors.forename: Alan G
authors.initials: AG
authors.lastname: Contreras
authors.forename: Bernardo
authors.initials: B
authors.lastname: Gabilondo
authors.forename: Julio
authors.initials: J
authors.lastname: Granados
authors.affiliation: Departamento de Trasplantes. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
authors.forename: Josefina
authors.initials: J
authors.lastname: Alberú
mesh_terms: D000367:Age Factors; D000906:Antibodies / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation; D015999:Multivariate Analysis; D044140:Receptor, Angiotensin, Type 1 / Q000276:immunology*; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D066027:Transplant Recipients
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D044140:Receptor, Angiotensin, Type 1