Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Transplant Proc. 2022 May;54(4):1141-1144. doi: 10.1016/j.transproceed.2022.02.040. Epub 2022 Apr 29.
Kidney function in patients undergoing hematopoietic stem cell transplant (HSCT) is frequently worsened by previous chemotherapy and exposure to a variety of nephrotoxic drugs. The aim of the study was to assess biomarkers of kidney injury in patients at least 3 months after HSCT under ambulatory care of the Hematology, Oncology and Internal Medicine Department. We studied 80 prevalent patients after allogeneic HSCT and 32 healthy volunteers to obtain normal ranges for biomarkers. In this cross-sectional study, the following biomarkers of kidney injury in urine were evaluated using commercially available assays: IGFBP7 and TIMP2, netrin-1, and semaphorin A2. All of the biomarkers studied were significantly higher in patients after HSCT compared with the healthy volunteers. When we divided patients according to kidney function (below and over 60 mL/min/1.73m2), we found that only concentration of IGFBP7 was significantly higher in 23 patients with chronic kidney disease (CKD) stage 3 relative to patients with an estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m2. All biomarkers in both subgroups of patients with eGFRs below and over 60 mL/min/1.73m2 were significantly higher relative to healthy volunteers. In univariate correlations, semaphorin A2 was related to netrin-1 (r = 0.47, P < .001), IGFBP7 (r = 0.35, P < .01), and TIMP2 (r = 0.32, P < .01), whereas IGFBP7 was positively related to serum creatinine (r = 0.38, P < .001) and inversely to eGFR (r = -0.36, P < .001). Patients after allogeneic HSCT, despite normal or near normal kidney function, show evidence of kidney injury.
在接受造血干细胞移植（HSCT）的患者中，肾功能经常因先前的化疗和暴露于多种肾毒性药物而恶化。本研究的目的是评估血液科、肿瘤科和内科门诊护理下至少 3 个月接受 HSCT 的患者的肾脏损伤生物标志物。我们研究了 80 例异基因 HSCT 后患者和 32 例健康志愿者，以获得生物标志物的正常范围。在这项横断面研究中，使用商业上可获得的测定法评估了尿液中肾脏损伤的以下生物标志物：IGFBP7 和 TIMP2、nectin-1 和 semaphorin A2。与健康志愿者相比，所有研究的生物标志物在 HSCT 后患者中均显着升高。当我们根据肾功能（<60 mL/min/1.73m2 和>60 mL/min/1.73m2）将患者分组时，我们发现仅在 23 例慢性肾脏病（CKD）3 期患者中 IGFBP7 浓度显着高于估计肾小球滤过率（eGFR）>60 mL/min/1.73m2 的患者。<60 mL/min/1.73m2 和>60 mL/min/1.73m2 的患者两个亚组的所有生物标志物均显着高于健康志愿者。在单变量相关性中，semaphorin A2 与 netrin-1（r=0.47，P<.001），IGFBP7（r=0.35，P<.01）和 TIMP2（r=0.32，P<.01）相关，而 IGFBP7 与血清肌酐呈正相关（r=0.38，P<.001），与 eGFR 呈负相关（r=-0.36，P<.001）。尽管异基因 HSCT 后患者的肾功能正常或接近正常，但仍有肾脏损伤的证据。
