Pretransplant urinary proteome analysis does not predict development of chronic kidney disease after liver transplantation

Liver Int. 2015 Jul;35(7):1893-901. doi: 10.1111/liv.12763. Epub 2015 Jan 20.

Abstract

Background & aims: Chronic kidney disease (CKD) is a common complication after liver transplantation. Kidney biopsies cannot be easily performed before liver transplantation to predict patients at high risk for CKD. The aim of our study was to determine whether pre-, peri- and post-transplant factors, as well as peptides present in preliver transplant urine samples were associated with loss in kidney function at 6 months post-transplantation using proteome analysis.

Methods: Eighty patients who underwent a liver transplantation and that had pretransplant glomerular filtration rate (GFR) value of ≥60 mL/min/1.73 m² (MDRD) were included in the study.

Results: GFR decreased significantly after transplantation. At month 6 post-transplantation, 40 patients displayed a CKD, i.e. eGFR of <60 mL/min/1.73 m², while the other 40 patients did not. Although thousands of peptides were identified, none was significantly associated with the development of CKD at 6 months after liver transplantation. Moreover, using a urinary peptidome classifier to detect preexisting CKD, no difference was found in CKD scores between the 2 groups. After analysis of a large number of pre-, peri- and post-transplant parameters, viral hepatitis as a cause for liver transplantation was the sole independent predictive factor for CKD. No difference in peptides with differential urinary abundance between patients who received a graft for virus related liver disease vs. all other causes of liver disease was observed.

Conclusion: Urinary peptidome analysis before liver transplantation failed to identify a peptide pattern associated with the development of CKD at 6 months after liver transplantation.

Keywords: chronic kidney disease; liver transplantation; proteome analysis; urine; viral hepatitis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / urine
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / metabolism*
  • Kidney / physiopathology
  • Liver Diseases / complications
  • Liver Diseases / diagnosis
  • Liver Diseases / surgery*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Proteinuria / complications
  • Proteinuria / diagnosis*
  • Proteinuria / urine
  • Proteomics / methods*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / etiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urinalysis

Substances

  • Biomarkers