Renal Allograft Failure Linked to Low Uromodulin Levels

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Kidney transplant recipients in the highest tertile of serum uromodulin concentration had a 2-fold increased risk of allograft failure compared with those in the lowest tertile.
Kidney transplant recipients in the highest tertile of serum uromodulin concentration had a 2-fold increased risk of allograft failure compared with those in the lowest tertile.
The following article is part of conference coverage from the NKF 2018 Spring Clinical Meetings in Austin hosted by the National Kidney Foundation. Renal & Urology News staff will be reporting on medical studies conducted by nephrologists and other specialists who are tops in their field in chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from NKF 2018.

AUSTIN, Texas—Low levels of uromodulin, a surrogate for less well-preserved renal tubular function, may predict a higher risk of renal allograft failure in long-term stable kidney transplant recipients (KTRs), investigators reported at the National Kidney Foundation's 2018 Spring Clinical Meetings.

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The finding is from a study of a randomly selected sub-cohort of 433 long-term KTRs who participated in the FAVORIT (Folic Acid for Vascular Outcome Reduction in Transplantation) trial. During follow-up, allograft failure occurred in 226 patients. The rate of allograft failure was 4.58, 2.45, and 1.57 per 100 person-years, respectively, for patients in the first, second, and third tertiles of serum modulin concentration, according to study findings presented by Andrew G. Bostom, MD, MS, of the Center for Primary Care & Prevention, Memorial Hospital of Rhode Island, Pawtucket, and colleagues. 

Compared with patients in the highest uromodulin tertile (greater than 74.05 to 309.59 ng/mL), those in the lowest tertile (5.62 to 46.81 ng/mL) had a significant 2-fold higher risk of allograft failure compared with those in the highest tertile in a model that adjusted for major established risk factors for renal allograft failure and cardiovascular disease. The investigators found no increased risk of allograft failure among patients in the middle tertile (greater than 46.81 to 74.05 ng/mL).

The study has been accepted for publication in the American Journal of Nephrology.

See more coverage from the National Kidney Foundation Spring Clinical meeting

Reference

Bostom A, Steubl D, Garimella P, et al. Serum uromodulin and risk of kidney allograft failure in long-term, stable kidney transplant recipients. Data presented at the National Kidney Foundation's 2018 Spring Clinical Meetings held in Austin, Texas from April 10-14. Poster 330.

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