Urine Test to Warn of Kidney Failure After Transplant

Researchers have developed the basis of an inexpensive urine test, based on proteins found in urine, that could warn of impending kidney failure or rejection following transplant surgery. Their work was presented in a special lecture to the American Transplant Congress in Boston (MA, USA) in May 2004.

To create a scientific foundation for the test, researchers analyzed 34 urine samples from 32 kidney patients at various stages after transplantation. Seventeen had organ rejection and 15 had no rejection. Rejection status was confirmed by biopsy. The researchers then identified 13 possible protein markers that were present in most of the urine samples from patients who had organ rejection but were absent from most nonrejection samples. Three other possible protein markers were found to be lower in patients' urine with the onset of transplant rejection. A separate analysis using a combination of biomarker candidates in a panel correctly identified 91% of the 34 urine samples.

"Frequent, noninvasive monitoring could allow doctors to better tailor immunosuppression drugs according to individual patients' needs, prescribing lower doses to more stable patients or increasing doses for patients who show early signs of rejection,” explained co-author Ernesto P. Molmenti, M.D., Ph.D., associate professor of surgery at Johns Hopkins (Baltimore, MD, USA; www.hopkinsmedicine.org).

Dr. Molmenti estimates that the test, when developed, will be far less expensive and much less painful than a standard biopsy costing hundreds of dollars, in which a doctor inserts a long needle into a patient's side to obtain a kidney tissue sample.




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