Kidney Int. 2008;74:1454-1460
Measuring levels of the chemokine fractalkine in the urine is a noninvasive way to detect acute rejection of renal allografts, according to Chinese investigators. High levels are associated with steroid resistance and poor outcome.
The researchers based the findings on a study involving 215 renal allograft recipients and 80 healthy controls. They looked at how well fractalkine and other chemokines could predict acute rejection.
Sixty-seven allograft recipients who experienced acute rejection had significantly higher levels of all urinary chemokines compared with controls or patients with chronic allograft nephropathy but stable renal function. Only changes in urinary fractalkine differentiated patients with acute rejection from those with acute tubular necrosis.
The seven patients who lost their grafts had greater urinary fractalkine, interferon-γ, and macrophage inflammatory protein-3α concentration than those patients with reversible acute rejection. Fractalkine was the best indicator for differentiating patients with steroid-sensitive acute rejection and in predicting graft loss.