Division of General Internal Medicine, Nephrology and Rheumatology, Department of Medicine D, University Hospital of Muenster, 48149, Muenster, Germany.
Sci Rep. 2021 Feb 12;11(1):3713. doi: 10.1038/s41598-021-83333-7.
The prognostic significance of suPAR in various kidney diseases has recently been demonstrated. Its role in transplantation-specific outcomes is still largely unknown. Therefore, we prospectively investigated the prognostic relevance of suPAR in patients before and one year after kidney transplantation (KTx). We included 100 patients who had received a kidney transplantation between 2013 and 2015. The plasma concentration of suPAR was measured by ELISA assay. In recipients of living donations (LD), pre-transplant suPAR levels were significantly lower than those of recipients of deceased donations (DD). After KTx, suPAR levels significantly declined in LD and DD recipients, without a detectable difference between both groups any more. Higher suPAR levels in recipients one year after KTx were associated with a more severe eGFR loss in the following three years in multivariable cox-regression (n = 82, p = 0.021). suPAR-levels above 6212 pg/ml one year after KTx are associated with eGFR loss > 30%, which occurred almost twice as fast as in patients with suPAR ≤ 6212 pg/ml (p < 0.001). Hence, suPAR level at one year mark might be a risk indicator of increased eGFR loss.
suPAR 在各种肾脏疾病中的预后意义最近已经得到证实。其在移植特异性结局中的作用仍知之甚少。因此，我们前瞻性地研究了 suPAR 在肾移植（KTx）前和移植后 1 年的患者中的预后相关性。我们纳入了 2013 年至 2015 年间接受肾移植的 100 例患者。通过 ELISA 法检测 suPAR 的血浆浓度。在活体供者（LD）受者中，移植前 suPAR 水平明显低于已故供者（DD）受者。在 KTx 后，LD 和 DD 受者的 suPAR 水平显著下降，两组之间不再有差异。在多变量 Cox 回归中（n=82），KTx 后 1 年 suPAR 水平较高的患者在接下来的 3 年内 eGFR 损失更严重（p=0.021）。KTx 后 1 年 suPAR 水平高于 6212 pg/ml 与 eGFR 损失>30%相关，这一速度几乎是 suPAR 水平低于或等于 6212 pg/ml 的患者的两倍（p<0.001）。因此，suPAR 水平在 1 年时可能是 eGFR 损失增加的风险指标。
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