Inflammation-associated graft loss in renal transplant recipients

Nephrol Dial Transplant. 2011 Nov;26(11):3756-61. doi: 10.1093/ndt/gfr163. Epub 2011 Apr 21.

Abstract

Background: Although short-term graft survival has improved substantially in renal transplant recipients, long-term graft survival has not improved over the last decades. The lack of knowledge of specific causes and risk factors has hampered improvements in long-term allograft survival. There is an uncertainty if inflammation is associated with late graft loss.

Methods: We examined, in a large prospective trial, the inflammation markers high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) and their association with chronic graft dysfunction. We collected data from the Assessment of Lescol in Renal Transplant trial, which recruited 2102 maintenance renal transplant recipients.

Results: Baseline values were hsCRP 3.8 ± 6.7 mg/L and IL-6 2.9 ± 1.9 pg/mL. Adjusted for traditional risk factors, hsCRP and IL-6 were independently associated with death-censored graft loss, the composite end points graft loss or death and doubling of serum creatinine, graft loss or death.

Conclusion: The inflammation markers hsCRP and IL-6 are associated with long-term graft outcomes in renal transplant recipients.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticholesteremic Agents / therapeutic use
  • C-Reactive Protein / metabolism*
  • Creatinine / blood
  • Double-Blind Method
  • Fatty Acids, Monounsaturated / therapeutic use
  • Female
  • Fluvastatin
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / blood*
  • Graft Rejection / etiology
  • Graft Rejection / mortality
  • Humans
  • Indoles / therapeutic use
  • Inflammation / blood*
  • Inflammation / etiology
  • Inflammation / mortality
  • Interleukin-6 / blood*
  • Kidney Diseases / complications*
  • Kidney Diseases / drug therapy
  • Kidney Diseases / surgery
  • Kidney Function Tests
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Prospective Studies
  • Survival Rate
  • Transplantation, Homologous

Substances

  • Anticholesteremic Agents
  • Fatty Acids, Monounsaturated
  • Indoles
  • Interleukin-6
  • Fluvastatin
  • C-Reactive Protein
  • Creatinine