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P-NGAL Day 1 predicts early but not one year graft function following deceased donor kidney transplantation - The CONTEXT study.

Journal article
Authors Marie B Nielsen
Nicoline V Krogstrup
Gertrude J Nieuwenhuijs-Moeke
M Oltean
Frank J M F Dor
Bente Jespersen
Henrik Birn
Published in PloS one
Volume 14
Issue 2
Pages e0212676
ISSN 1932-6203
Publication year 2019
Published at
Pages e0212676
Language en
Keywords Aged, Allografts, physiopathology, Biomarkers, blood, urine, Creatinine, blood, Delayed Graft Function, diagnosis, physiopathology, Female, Glomerular Filtration Rate, Graft Survival, Humans, Kidney, physiopathology, Kidney Failure, Chronic, blood, therapy, urine, Kidney Transplantation, adverse effects, Lipocalin-2, blood, urine, Male, Middle Aged, Predictive Value of Tests, Prognosis, Renal Dialysis, statistics & numerical data, Time Factors
Subject categories Transplantation surgery, Kidney diseases


Early markers to predict delayed kidney graft function (DGF) may support clinical management. We studied the ability of four biomarkers (neutrophil gelatinase associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), cystatin C, and YKL-40) to predict DGF after deceased donor transplantation, and their association with early graft function and GFR at three and twelve months.225 deceased donor kidney transplant recipients were included. Biomarkers were measured using automated assays or ELISA. We calculated their ability to predict the need for dialysis post-transplant and correlated with the estimated time to a 50% reduction in plasma creatinine (tCr50), measured glomerular filtration rate (mGFR) and estimated GFR (eGFR).All biomarkers measured at Day 1, except urinary L-FABP, significantly correlated with tCr50 and mGFR at Day 5. Plasma NGAL at Day 1 and a timed urine output predicted DGF (AUC = 0.91 and AUC 0.98). Nil or only weak correlations were identified between early biomarker levels and mGFR or eGFR at three or twelve months.High plasma NGAL at Day 1 predicts DGF and is associated with initial graft function, but may not prove better than P-creatinine or a timed urine output. Early biomarker levels do not correlate with one-year graft NCT01395719.

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