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신장 이식 후 신기능의 예후인자로서 Urine Liver-type fatty acid-binding protein의 유용성에 관한 연구 원문보기
Urine liver-type fatty acid-binding protein predicts graft outcome up to 2 years after kidney transplantation

  • 저자

    양지현

  • 학위수여기관

    고려대학교 대학원

  • 학위구분

    국내석사

  • 학과

    의학과 내과학전공

  • 지도교수

    조상경

  • 발행년도

    2014

  • 총페이지

    14 p.

  • 키워드

    Kidney transplantation Urine L-FABP Graft outcome;

  • 언어

    eng

  • 원문 URL

    http://www.riss.kr/link?id=T13541957&outLink=K  

  • 초록

    Background. Several new biomarkers for the detection of early tubular injury have been investigated in kidney transplant recipients. We recently identified day 2 urinary neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of slow graft function and adverse 1-year outcome. In the present study, we further investigated the value of urinary NGAL and liver-type fatty acid binding protein (L-FABP) for predicting long-term graft outcomes up to 2 years. Methods. This study was a single-center, prospective observational study. Serial urinary NGAL and L-FABP levels at 0 hours, 2 days, and 6 days after kidney transplantation (KT) were measured, and the clinical data were assessed during the 2-year period after KT. Results. During the 2-year follow-up period, 13 (18.8%), 5 (7.2%), and 4 (5.8%) patients were diagnosed with acute T-cell-mediated rejection, acute antibody-mediated rejection (AMR) and chronic AMR, respectively. In addition, 10 patients (14.3%) developed calcineurin inhibitor toxicity and 6 (8.7%) developed BK viremia. The mean estimated glomerular filtration rates (eGFR) at 1 and 2 years after KT were 65.1±19.1 and 58.5±22.6 mL/min/1.73 m2, respectively, When poor long-term graft function was defined as eGFR of less than 50 mL/min/1.73 m2 at 2 years, elderly donors, acute rejection, and high 0-hour urinary L-FABP levels were significant risk factors. Furthermore, in rejection-free patients, L-FABP was strongly associated with poor long-term graft function (P = .006). Multivariate logistic regression analysis showed that high 0-hour L-FABP (P = .015) and acute rejection (P = .006) were independent factors predicting poor long-term graft function. Receiver operating characteristic analysis showed that the area under the curve for urinary L-FABP was 0.692 (P = .036). Conclusions. Our results suggest that urinary L-FABP may be a useful predictor of adverse long-term outcomes in KT patients.


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