Tubulointerstitial Fibrosis of Living Donor Kidneys Associates with Urinary Monocyte Chemoattractant Protein 1

Xiangling Wang, John C. Lieske, Mariam P. Alexander, Muthuvel Jayachandran, Aleksandar Denic, Jerry Mathew, Lilach O. Lerman, Walter K. Kremers, Joseph J. Larson, Andrew D. Rule

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Non-invasive biomarkers that detect occult pathology in patients with normal glomerular filtration rate (GFR) and normal urine albumin excretion may help identify patients at risk for chronic kidney diseases. Methods: Two promising biomarkers of interstitial fibrosis, urinary monocyte chemoattractant protein 1 (MCP-1) and collagen IV, were assayed among 634 living kidney donors from 2005 to 2011, who had both a frozen pre-donation spot urine sample and a core needle biopsy of their donated kidney at transplantation (time zero biopsy'). The association of urine MCP- 1 and collagen IV with kidney function (GFR and urine albumin excretion), kidney volume on computed tomographic imaging and histological findings was assessed. Results: The mean SD age was 45 12 years, 24-hour urine albumin was 4 ± 7 mg and measured GFR (mGFR) was 102 ± 18 ml/ min/1.73 m 2 . The median (25th-75th percentile) urine level of MCP-1 was 146 (54-258) pg/ml and of collagen IV was 2.0 (1.0-3.5) ?g/l. Higher urine MCP-1 associated with higher 24- hour urine albumin excretion; higher urine collagen IV asso- ciated with male gender. On kidney biopsy, any interstitial fibrosis was present in 22% and fibrosis >5% in 4% of donors. The mean MCP-1/Cr ratio was 1.49 pg/mg for 0% fibrosis, 1.80 pg/mg for 1-5% fibrosis, 2.33 pg/mg for 6-10% fibrosis and 4.33 pg/mg for >10% fibrosis. After adjustment for age, sex, mGFR and 24-hour urine albumin, higher urine MCP-1 but not collagen IV associated with interstitial fibrosis and tubular atrophy. Conclusion: Urine MCP-1 may detect early tubulointerstitial fibrosis in adults with normal kidney function.

Original languageEnglish (US)
Pages (from-to)454-459
Number of pages6
JournalAmerican journal of nephrology
Volume43
Issue number6
DOIs
StatePublished - Jul 1 2016

Keywords

  • Collagen type IV Tubulointerstitial fibrosis
  • Implantation biopsies
  • Living kidney donors
  • Monocyte chemoattractant protein 1

ASJC Scopus subject areas

  • Nephrology

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