Urine Biomarker Helps Predict Delayed Graft Function

A diagnostic test for early detection of acute kidney injury helped predict delayed graft function (DGF) in kidney transplant patients.

A study examined how serial urine neutrophil gelatinase-associated lipocalin (NGAL) concentrations change over time following kidney transplants and whether urine concentrations of NGAL could predict the onset of delayed graft function or prolonged delayed graft function.

One-hundred and seventy-six renal transplant patients were evaluated in the study. Urine samples were collected before transplantation and for several days afterward. Seventy patients had DGF and 26 of them were prolonged. The NGAL assay was performed by a two-step chemiluminescent microparticle immunoassay on the Architect standardized clinical platform of Abbott Diagnostics (Abbott Park, IL, USA).

The patients who developed DGF had a significantly slower decrease in urinary NGAL compared to those without DGF. Urine NGAL levels measured a day following transplant predicted prolonged DGF (14 days or longer), which had significantly worse one-year graft survival (73 %) compared with shorter DGF (100 percent).

The scientists concluded that urine NGAL measurements could predict prolonged DGF and identify patients with severe kidney injury and inferior long-term organ survival. They added that the test also provides a simple method to quantify recovery from kidney injury.

"Day one urinary NGAL predicted DGF even when it was not clinically expected early on, and importantly, it predicted prolonged DGF that led to worse graft survival," according to Dr. Maria Hollmen, MD, Helsinki University Hospital, (Helsinki, Finland) who led the study.

The Finnish study was published in the September 2010 edition of Kidney International, the journal of the International Society of Nephrology.

DGF and prolonged DGF can cause acute organ rejection, require patients to undergo dialysis, prolong post-transplant hospital stays, and increase postoperative care costs. According to the study's authors, there is a need for an effective test to help predict delayed graft function soon after transplantation, which could help in developing therapeutic interventions to prevent DGF.

Abbott (Abbott Park, IL, USA) introduced the automated urine NGAL assay in Europe on Architect, the company's flagship instrument system.

Related Links:
Helsinki University Hospital
Abbott Diagnostics