Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
U1048, Institut of Cardiovascular and Metabolic Disease, Institut National de la Santé et de la Recherche Médicale (INSERM), Toulouse, France.
Liver Int. 2015 Jul;35(7):1893-901. doi: 10.1111/liv.12763. Epub 2015 Jan 20.
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.
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.
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.
Urinary peptidome analysis before liver transplantation failed to identify a peptide pattern associated with the development of CKD at 6 months after liver transplantation.
慢性肾脏病（CKD）是肝移植后的常见并发症。在肝移植前，由于无法进行肾脏活检，因此难以预测发生 CKD 的高风险患者。本研究的目的是通过蛋白质组分析，确定肝移植前、围手术期和移植后因素以及肝移植前尿液样本中存在的肽类是否与移植后 6 个月肾功能丧失有关。
本研究纳入了 80 例接受肝移植且移植前肾小球滤过率（GFR）值≥60 mL/min/1.73 m²（MDRD）的患者。
移植后 GFR 显著下降。移植后 6 个月时，40 例患者出现 CKD，即 eGFR<60 mL/min/1.73 m²，而其余 40 例患者没有。尽管鉴定出了数千种肽类，但没有一种与肝移植后 6 个月发生 CKD 显著相关。此外，使用尿肽组学分类器来检测预先存在的 CKD，两组之间的 CKD 评分没有差异。分析大量肝移植前、围手术期和移植后参数后，发现病毒性肝炎是 CKD 的唯一独立预测因素。未发现患有病毒相关性肝病和其他肝病患者的尿液中具有差异丰度的肽类存在差异。
肝移植前的尿肽组分析未能确定与肝移植后 6 个月发生 CKD 相关的肽模式。
