Plasma NGAL and glomerular filtration rate in cardiac transplant recipients treated with standard or reduced calcineurin inhibitor levels.

Gustafsson, Finn; Gude, Einar; Sigurdardottir, Vilborg; Aukrust, Pål; Solbu, Dag; Goetze, Jens-Peter; Gullestad, Lars (2014). Plasma NGAL and glomerular filtration rate in cardiac transplant recipients treated with standard or reduced calcineurin inhibitor levels. Biomarkers in medicine, 8(2), pp. 239-245. Future Medicine 10.2217/bmm.13.95

Text Gustafsson F, Sigurdardottir V et.al_NGAL_NOCTET_2013.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (605kB) | Request a copy

AIM

Predictors of renal recovery following conversion from calcineurin inhibitor- to proliferation signal inhibitor-based therapy are lacking. We hypothesized that plasma NGAL (P-NGAL) could predict improvement in glomerular filtration rate (GFR) after conversion to everolimus.

PATIENTS & METHODS

P-NGAL was measured in 88 cardiac transplantation patients (median 5 years post-transplant) with renal dysfunction randomized to continuation of conventional calcineurin inhibitor-based immunosuppression or switching to an everolimus-based regimen.

RESULTS

P-NGAL correlated with measured GFR (mGFR) at baseline (R(2) = 0.21; p < 0.001). Randomization to everolimus improved mGFR after 1 year (median [25-75 % percentiles]: ΔmGFR 5.5 [-0.5-11.5] vs -1 [-7-4] ml/min/1.73 m(2); p = 0.006). Baseline P-NGAL predicted mGFR after 1 year (R(2) = 0.18; p < 0.001), but this association disappeared after controlling for baseline mGFR.

CONCLUSION

P-NGAL and GFR correlate with renal dysfunction in long-term heart transplantation recipients. P-NGAL did not predict improvement of renal function after conversion to everolimus-based immunosuppression.

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