title: [Evaluation of markers for renal graft dysfunction in patients with type 1 diabetes mellitus after kidney transplantation and simultaneous pancreas-kidney transplantation].
abstract: OBJECTIVE
  To study the markers of renal graft dysfunction in patients with type 1 diabetes mellitus (T1DM) after kidney transplantation (KT) and simultaneous pancreas-kidney transplantation (SPKT).
  
  
  METHODS
  The investigation enrolled 20 patients after successful SPKT and 41 patients after KT (of them 21 received continuous subcutaneous insulin infusion with an insulin doser; 20 had multiple insulin injections). The periods after KT and SPKT at patient inclusion were 8 (7; 8) and 11 (8; 18) months, respectively. A control group comprised 15 patients with T1DM without diabetic nephropathy. The patients were matched for gender, age, and T1DM duration. At a 9-month follow-up, the main biomarkers of kidney graft dysfunction were identified using the standard kits: Cystatin C (Cys C; serum; urine), NGAL, KIM-1, Podocin, Nephrin, IL-18, MMP-9 (urine), TGF-β1, VEGF-A, and Osteopontin (OPN; serum). Fasting blood was taken; a morning urinary portion was examined.
  
  
  RESULTS
  The posttransplantation glomerular filtration rate (GFR) in the patients corresponded to Stage C2; albuminuria did to Category A1 chronic kidney disease. Despite successful SPKT in the group of patients with T1DM, as in that of patients after isolated KT, there was a statistically significant increase in the level of kidney dysfunction markers (Cys C, NGAL, Podocin, and OPN) versus the control group regardless of the compensation for glucose metabolism. compensation. It was found that the level of Cys C was high and correlated negatively with GFR (r=-0.36; p<0.05) and positively with the level of albuminuria (r=0.40; p<0.05). There was also a direct correlation of urinary podocin concentrations with blood creatinine levels (r=0.35; p<0.05) and that of NGAL with albuminuria (r=0.35; p<0.05) in recipients after transplantation.
  
  
  CONCLUSIONS
  The high levels of biomarkers for kidney graft dysfunction in the examinees (including subjects after SPKT) reflect the persistence of graft microstructural injuries in clinically stable function.
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: A M
authors: AM
authors: Glazunova
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: M S
authors: MS
authors: Arutyunova
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: E V
authors: EV
authors: Tarasov
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: L V
authors: LV
authors: Nikankina
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: A V
authors: AV
authors: Ilyin
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: M Sh
authors: MS
authors: Shamkhalova
authors: Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors: M V
authors: MV
authors: Shestakova
authors: Acad. V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Ministry of Health of Russia, Moscow, Russia.
authors: Ya G
authors: YG
authors: Moysyuk
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000652:urine; D055316:Cystatin C / Q000097:blood / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D013223:Statistics as Topic; D019737:Transplants / Q000378:metabolism / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D000071068:Lipocalin-2