Plasma Procalcitonin Is an Independent Predictor of Graft Failure Late After Renal Transplantation

Rutger M. van Ree, Aiko P. J. de Vries, Leendert H. Oterdoom, Marc A. Seelen, Ron T. Gansevoort, Jan P. Schouten, Joachim Struck, Gerjan Navis, Reinold O. B. Gans, Jaap J. Homan van der Heide, Willem J. van Son, Stephan J. L. Bakker*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Scopus)

Abstract

Background. Chronic low-grade inflammation is involved in chronic transplant dysfunction after renal transplantation. Procalcitonin (PCT), known to reflect microbial inflammation, may also reflect ongoing noninfectious chronic low-grade inflammation in organ parenchyma, including transplanted kidneys. We aimed to compare predictive performance of plasma PCT for development of graft failure in renal transplant recipients (RTR) with that of high-sensitivity C-reactive protein (hsCRP), an established marker of systemic chronic low-grade inflammation.

Methods. We included 575 RTR with functioning grafts for more than or equal to 1 year at a median (interquartile range) time of 6.1 (2.9-11.7) years posttransplant. PCT was determined using an Ultrasensitive immunoluminometric assay and hsCRP using high-sensitivity enzyme-linked immunosorbent assay.

Results. Median (interquartile range) plasma PCT and hsCRP concentrations were 0.023 (0.017-0.036) ng/mL and 2.1 (0.8-4.9) mg/L, respectively. After a median (interquartile range) of 5.2 (4.5-5.7) years of follow-up, incidence of graft failure was 0.5%, 2.6%, and 18.5% according to increasing PCT tertiles (P

Conclusion. We identified plasma PCT as a strong and an independent predictor of graft failure in RTR. These data suggest that PCT in RTR reflects ongoing inflammation in parenchyma of transplanted kidneys. Further studies are required to investigate whether PCT could be of use as an early biomarker for chronic transplant dysfunction.

Original languageEnglish
Pages (from-to)279-287
Number of pages9
JournalTransplantation
Volume88
Issue number2
DOIs
Publication statusPublished - 27-Jul-2009

Keywords

  • Chronic transplant dysfunction
  • C-reactive protein
  • Procalcitonin
  • Renal transplantation
  • Recipient survival
  • C-REACTIVE PROTEIN
  • CORONARY-HEART-DISEASE
  • CALCITONIN-I GENE
  • INSULIN-RESISTANCE
  • ALLOGRAFT DYSFUNCTION
  • INFLAMMATORY DISEASE
  • SERUM PROCALCITONIN
  • ELIMINATION RATE
  • ADIPOSE-TISSUE
  • INFECTION

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