Fibrogenesis in Kidney Transplant: Dysfunction Progress Biomarkers

• Published in: Transplantation proceedings Vol. 49; no. 4; pp. 787 - 791
• Main Authors: Costa, J.S, Alves, R, Sousa, V, Marinho, C, Romãozinho, C, Santos, L, Macário, F, Pratas, J, Prado e Castro, L, Campos, M, Figueiredo, A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017
• Subjects: Actins - analysis; Adult; Allografts - chemistry; Allografts - physiopathology; Biomarkers - analysis; Biopsy - methods; Cadherins - analysis; Disease Progression; Female; Fibrosis; Glomerular Filtration Rate; Graft Survival - physiology; Humans; Kidney - chemistry; Kidney - physiopathology; Kidney Diseases - etiology; Kidney Diseases - physiopathology; Kidney Diseases - therapy; Kidney Glomerulus - chemistry; Kidney Glomerulus - physiopathology; Kidney Transplantation - adverse effects; Male; Middle Aged; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Postoperative Complications - therapy; Renal Dialysis; Retrospective Studies; Surgery
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2017.01.063

Abstract Introduction Fibrogenesis markers, such as alpha-actin (AA), CD163 (macrophages), and E-cadherin, have been studied as chronic kidney allograft injury (CAI) predictors, a major cause of allograft failure. Objective Investigate the value of these markers in predicting CAI and initiation of dialysis. Materials and Methods Retrospective analysis of 26 kidney allograft biopsies (from 22 patients with CAI) during 2 years, evaluating intensity and percentage of marked cells on glomeruli and tubulointerstitial compartment. At the time of the biopsy, patients were 45.5 ± 15.8 years and 4.2 years after transplant, and they had a mean glomerular filtration rate (GFR) of 25.8 ± 9.9 mL/min. From an average of 8.5 glomeruli per biopsy, there was ≤25% sclerosis in 17 cases, 26% to 50% in 5, and >50% in 4. Interstitial fibrosis or tubular atrophy affected ≤25% of cortical area in 14 cases, 26% to 50% in 8, and >50% in 2. Twelve patients started dialysis 5.8 ± 4.7 years after transplant, with an average GFR 20.9 mL/min at the time of the biopsy. Results There was a higher intensity and percentage of CD163-marked cells in the tubulointerstitial compartment in advanced interstitial fibrosis. We found an association between intensity of AA in the tubulointerstitial compartment and initiation of dialysis ( P  = .003) and a negative correlation between intensity of E-cadherin loss and GFR ( r  = −0.56, P  = .012). Conclusions In our study, intensity of tubulointerstitial AA was shown to be a predictor of initiation of dialysis, and E-cadherin loss intensity was associated to CAI progression. However, prospective and larger studies are needed to evaluate the predictive value of these markers.