Urinary liver-type fatty-acid binding protein is independently associated with graft failure in outpatient kidney transplant recipients

Yepes-Calderón, M., Sotomayor, C. G., Pena, M., Eisenga, M. F., Gans, R. O. B., Berger, S. P., Moers, C., Sugaya, T., Doekharan, D., Navis, G. J., van den Born, J. & Bakker, S. J. L., 18-Sep-2020, In : American Journal of Transplantation. 11 p.

Research output: Contribution to journalArticleAcademicpeer-review

Urinary liver-type fatty-acid binding protein (uL-FABP) is a biomarker of kidney hypoxia and ischemia, and thus offers a novel approach to identify early kidney insults associated with increased risk of graft failure in outpatient kidney transplant recipients (KTR). We investigated whether uL-FABP is associated with graft failure and whether it improves risk prediction. We studied a cohort of 638 outpatient KTR with a functional graft ≥1-year. During a median follow-up of 5.3 years, 80 KTR developed graft failure. uL-FABP (median 2.11, interquartile range 0.93-7.37 µg/24-hours) was prospectively associated with risk of graft failure (hazard ratio 1.75; 95% confidence interval 1.27-2.41 per 1-standard deviation increment; P=0.001), independent of potential confounders including estimated glomerular filtration rate and proteinuria. uL-FABP showed excellent discrimination ability for graft failure (c-statistic of 0.83) and its addition to a prediction model composed by established clinical predictors of graft failure significantly improved the c-statistic to 0.89 (P for F-test <0.001). These results were robust to several sensitivity analyses. Further validation studies are warranted to evaluate the potential use of a risk-prediction model including uL-FABP to improve identification of outpatient KTR at high-risk of graft failure in clinical care.

Original languageEnglish
Number of pages11
JournalAmerican Journal of Transplantation
Publication statusE-pub ahead of print - 18-Sep-2020

ID: 134253515