Uromodulin Associated with Reduced Risk for Graft Failure

Austin, TexasAndrew Bostom, MD, of the Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, recently conducted an analysis of longitudinal follow-up data from a study of 91 recipients of kidney transplantation. The analysis was designed to examine the association between baseline serum uromodulin and the development of graft failure.

Uromodulin is a kidney-derived glycoprotein and putative tubular function index. During longitudinal follow-up of a previous study, higher levels of uromodulin were associated with reduced risk for graft failure. That study included 91 recipients of kidney transplantation. There were 13 graft failure events among the 91 patients.

Using a case-cohort design, Dr. Bostom performed an analysis of data from the FAVORIT (Folic Acid for Vascular Outcome Reduction in Transplantation) trial to examine the association between baseline serum uromodulin and the development of graft failure. Results of the analysis were reported during a poster session at the NKF 2018 Spring Clinical Meetings in a poster titled Higher Serum Uromodulin Levels Are Independently Associated with Lower Risk for Graft Failure in Chronic, Stable Kidney Transplant Recipients.

FAVORIT included 613 chronic, stable kidney transplant recipients; the analysis included data on a random subcohort with mean baseline serum uromodulin level of 67.8 ng/mL (standard deviation, ± 39.7 ng/mL). During a median of 4.1 years of follow-up, there were 226 graft failure events among the 613 transplant recipients.

In unadjusted, weighted Cox proportional hazards models, there was an association between each standard deviation higher (+39.7 ng/mL) of uromodulin and a 41% lower risk for graft failure. Following adjustment for age, sex, smoking status, graft type, graft vintage, systolic blood pressure, serum phosphorus, estimated glomerular filtration rate (mean 45.5 mL/min/1.73m2), and natural log urinary albumin creatinine (mean, 209.3 mcg/mL), the association was attenuated, but persisted at 21% (hazard ratio, 0.79; 95% confidence interval, 0.64-0.97).

“Higher serum uromodulin, a possible indicator of better preserved renal tubular function, was independently associated with reduced risk for graft failure in a large, multiethnic cohort of chronic, stable kidney transplant recipients,” Dr. Bostom said.

Source: Bostom A. Higher serum uromodulin levels are independently associated with lower risk for graft failure in chronic, stable kidney transplant recipients. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.