Group IIA Secretory Phospholipase A(2) Predicts Graft Failure and Mortality in Renal Transplant Recipients by Mediating Decreased Kidney Function

Wijtske Annema, Jan Freark de Boer, Arne Dikkers, Lidiya G. Dimova, Markus van der Giet, Stephan J. L. Bakker, Uwe J. F. Tietge*

*Bijbehorende auteur voor dit werk

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The acute phase protein group IIA secretory phospholipase A(2) (sPLA(2)-IIA) has intrinsic proatherosclerotic properties. The present prospective cohort study investigated whether plasma sPLA(2)-IIA associates with graft failure, cardiovascular, and all-cause mortality in renal transplant recipients (RTRs), patients with accelerated atherosclerosis formation both systemically and within the graft. In 511 RTRs from a single academic center with stable graft function >1 year, baseline plasma sPLA(2)-IIA was determined by ELISA. Primary end points were death-censored graft failure and mortality (median follow-up, 7.0 years). Baseline sPLA(2)-IIA was higher in RTRs than in healthy controls (median 384 ng/dL (range 86-6951) vs. 185 ng/dL (range 104-271), p <0.001). Kaplan-Meier analysis demonstrated increased risk for graft failure (p = 0.002), as well as cardiovascular (p <0.001) and all-cause mortality (p <0.001), with increasing sPLA(2)-IIA quartiles. Cox regression showed strong associations of sPLA(2)-IIA with increased risks of graft failure (hazard ratio (HR) = 1.42 (1.11-1.83), p = 0.006), as well as cardiovascular (HR = 1.48 (1.18 1.85), p = 0.001) and all-cause mortality (HR = 1.39 (1.17 1.64), p <0.001), dependent on parameters of kidney function. Renal function during follow-up declined faster in RTRs with higher baseline sPLA(2)-IIA levels. In RTRs, sPLA(2)-IIA is a significant predictive biomarker for chronic graft failure, as well as overall and cardiovascular disease mortality dependent on kidney function. This dependency is conceivably explained by sPLA(2)-IIA impacting negatively on kidney function.

Originele taal-2English
Aantal pagina's14
TijdschriftJournal of Clinical Medicine
Nummer van het tijdschrift5
StatusPublished - mei-2020

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