Time course of low molecular weight proteins in the early kidney transplantation period -: influence of corticosteroids

被引:49
作者
Pöge, U
Gerhardt, T
Bökenkamp, A
Stoffel-Wagner, B
Klehr, HU
Sauerbruch, T
Woitas, RP
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Pediat, Amsterdam, Netherlands
[2] Univ Bonn, Dept Internal Med 1, D-5300 Bonn, Germany
[3] Univ Bonn, Dept Clin Biochem, D-5300 Bonn, Germany
关键词
beta-2; microglobulin; creatinine; cystatin C; kidney transplantation;
D O I
10.1093/ndt/gfh341
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Cystatin C (Cys C) is an established new marker of renal function in patients with various renal diseases and in kidney transplantation. However, few data are available for the early post-transplantation period. Methods. Twenty-two patients who underwent renal transplantation (RTx) were evaluated for the kinetics of Cys C from day 0 to 14 in relation to creatinine and beta-2 microglobulin (B2MG). Blood samples were obtained immediately before and after transplantation and on a daily basis thereafter. Serum levels before transplantation (100%) were used to calculate reduction ratios. Results. The decrease of the analytes differed considerably: immediately after RTx Cys C declined by 27.3% (P < 0.01). However, after 3 days, on average, all patients showed a significant increase in Cys C levels (15 +/- 2.5%; P < 0.01). B2MG levels fell quickly by 55.4 and 73.8% after days 1 and 7, respectively, and remained stable thereafter. In contrast, creatinine did not decease immediately after RTx but fell slowly by 67.5% at the end of the study. Prior to rejection, all analytes showed a similar behaviour. Rejection treatment with high-dose methylprednisolone induced a significant increase in Cys C (+22.8 +/- 7.9%, P < 0.05), while in parallel, creatinine and B2MG decreased (-12.9 +/- 3.4 and -8.4 +/- 6.89%). Conclusions. Corticosteroid treatment for induction of immunosuppression or rejection therapy significantly induces Cys C, but decreases B2MG. Cys C and B2MG are not helpful in establishing the diagnosis of rejection earlier. Thus, our data indicate that Cys C and B2MG testing does not accurately reflect changes in the glomerular filtration rate early after transplantation.
引用
收藏
页码:2858 / 2863
页数:6
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