Urinary actin, interleukin-6, and interleukin-8 may predict sustained ARF after ischemic injury in renal allografts

Osun Kwon, Bruce Molitoris, Mark Pescovitz, Katherine Kelly

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Background: Cellular damage and inflammation after ischemia contribute to sustained acute renal failure (ARF). Methods: To quantify cellular damage and inflammation in postischemic ARF and identify markers of renal functional outcome, urine specimens from 40 renal allograft recipients, including 30 cadaveric (9 "sustained ARF" and 21 "recovery" subjects) and 10 living donor allografts ("LD"), were analyzed for actin, γ-glutamyl transpeptidase (GGTP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) during the first posttransplant week. Results: On day 0, urinary actin, GGTP, IL-6, and IL-8 were elevated in recipients destined to have sustained ARF compared with those destined to recover. Median values per gram of urine creatinine in the sustained ARF, recovery, and LD groups were 263.9, 0.0, and 0.0 μg for actin; 5000.0, 892.9, and 5555.6 U for GGTP; 193.1, 27.2, and 10.5 ng for IL-6; and 382.0, 17.8, and 18.5 ng for IL-8, respectively. In contrast, urinary LDH and TNF-α increased in recipients with recovering function compared with those who had sustained ARF. The corresponding median values were 36.7 and 16.3 U (recovery versus sustained ARF) for LDH, and 18.4 and 7.6 ng (LD versus sustained ARF) for TNF-α. Computational analyses using the Receiver Operating Characteristic Curve found that elevated urinary actin, IL-6, and IL-8 on day 0 were strong predictors of sustained ARF, where the calculated areas under the curve were 0.75, 0.91, and 0.82, respectively. Conclusion: Increased urinary actin, IL-6, and IL-8 may be useful markers for the prediction of sustained ARF after ischemia.

Original languageEnglish (US)
Pages (from-to)1074-1087
Number of pages14
JournalAmerican Journal of Kidney Diseases
Volume41
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Interleukin-8
Acute Kidney Injury
Allografts
Actins
Interleukin-6
Kidney
Wounds and Injuries
gamma-Glutamyltransferase
L-Lactate Dehydrogenase
Tumor Necrosis Factor-alpha
Ischemia
Urine
Inflammation
Living Donors
ROC Curve
Area Under Curve
Creatinine

Keywords

  • Actin
  • Acute renal failure (ARF)
  • Gamma-glutamyl transpeptidase (GGTP)
  • Interleukin-6 (IL-6)
  • Interleukin-8 (IL-8)
  • Ischemia
  • Lactate dehydrogenase (LDH)
  • Lymphokine
  • Renal allograft
  • Tumor necrosis factor-alpha (TNF-α)
  • Urine

ASJC Scopus subject areas

  • Nephrology

Cite this

Urinary actin, interleukin-6, and interleukin-8 may predict sustained ARF after ischemic injury in renal allografts. / Kwon, Osun; Molitoris, Bruce; Pescovitz, Mark; Kelly, Katherine.

In: American Journal of Kidney Diseases, Vol. 41, No. 5, 01.05.2003, p. 1074-1087.

Research output: Contribution to journalArticle

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TY - JOUR

T1 - Urinary actin, interleukin-6, and interleukin-8 may predict sustained ARF after ischemic injury in renal allografts

AU - Kwon, Osun

AU - Molitoris, Bruce

AU - Pescovitz, Mark

AU - Kelly, Katherine

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Background: Cellular damage and inflammation after ischemia contribute to sustained acute renal failure (ARF). Methods: To quantify cellular damage and inflammation in postischemic ARF and identify markers of renal functional outcome, urine specimens from 40 renal allograft recipients, including 30 cadaveric (9 "sustained ARF" and 21 "recovery" subjects) and 10 living donor allografts ("LD"), were analyzed for actin, γ-glutamyl transpeptidase (GGTP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) during the first posttransplant week. Results: On day 0, urinary actin, GGTP, IL-6, and IL-8 were elevated in recipients destined to have sustained ARF compared with those destined to recover. Median values per gram of urine creatinine in the sustained ARF, recovery, and LD groups were 263.9, 0.0, and 0.0 μg for actin; 5000.0, 892.9, and 5555.6 U for GGTP; 193.1, 27.2, and 10.5 ng for IL-6; and 382.0, 17.8, and 18.5 ng for IL-8, respectively. In contrast, urinary LDH and TNF-α increased in recipients with recovering function compared with those who had sustained ARF. The corresponding median values were 36.7 and 16.3 U (recovery versus sustained ARF) for LDH, and 18.4 and 7.6 ng (LD versus sustained ARF) for TNF-α. Computational analyses using the Receiver Operating Characteristic Curve found that elevated urinary actin, IL-6, and IL-8 on day 0 were strong predictors of sustained ARF, where the calculated areas under the curve were 0.75, 0.91, and 0.82, respectively. Conclusion: Increased urinary actin, IL-6, and IL-8 may be useful markers for the prediction of sustained ARF after ischemia.

AB - Background: Cellular damage and inflammation after ischemia contribute to sustained acute renal failure (ARF). Methods: To quantify cellular damage and inflammation in postischemic ARF and identify markers of renal functional outcome, urine specimens from 40 renal allograft recipients, including 30 cadaveric (9 "sustained ARF" and 21 "recovery" subjects) and 10 living donor allografts ("LD"), were analyzed for actin, γ-glutamyl transpeptidase (GGTP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) during the first posttransplant week. Results: On day 0, urinary actin, GGTP, IL-6, and IL-8 were elevated in recipients destined to have sustained ARF compared with those destined to recover. Median values per gram of urine creatinine in the sustained ARF, recovery, and LD groups were 263.9, 0.0, and 0.0 μg for actin; 5000.0, 892.9, and 5555.6 U for GGTP; 193.1, 27.2, and 10.5 ng for IL-6; and 382.0, 17.8, and 18.5 ng for IL-8, respectively. In contrast, urinary LDH and TNF-α increased in recipients with recovering function compared with those who had sustained ARF. The corresponding median values were 36.7 and 16.3 U (recovery versus sustained ARF) for LDH, and 18.4 and 7.6 ng (LD versus sustained ARF) for TNF-α. Computational analyses using the Receiver Operating Characteristic Curve found that elevated urinary actin, IL-6, and IL-8 on day 0 were strong predictors of sustained ARF, where the calculated areas under the curve were 0.75, 0.91, and 0.82, respectively. Conclusion: Increased urinary actin, IL-6, and IL-8 may be useful markers for the prediction of sustained ARF after ischemia.

KW - Actin

KW - Acute renal failure (ARF)

KW - Gamma-glutamyl transpeptidase (GGTP)

KW - Interleukin-6 (IL-6)

KW - Interleukin-8 (IL-8)

KW - Ischemia

KW - Lactate dehydrogenase (LDH)

KW - Lymphokine

KW - Renal allograft

KW - Tumor necrosis factor-alpha (TNF-α)

KW - Urine

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JO - American Journal of Kidney Diseases

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