ArticleClinical journal of the American Society of Nephrology : CJASN2015
Urinary elafin and kidney injury in hematopoietic cell transplant recipients.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Renal resistive index and shear wave elastography in assessment of kidney function after allogeneic hematopoietic cell transplantation: a pilot prospective observational study.Polish journal of radiology · 2026Article
- A road map for uniform, comprehensive long-term follow-up after curative therapy for sickle cell disease.Blood advances · 2025Review
- Allogeneic T cells cause acute renal injury after hematopoietic cell transplantation.Blood advances · 2023Article
- Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force.Transplantation and cellular therapy · 2022Review
- Recent Advances of Acute Kidney Injury in Hematopoietic Cell Transplantation.Frontiers in immunology · 2021Review
- Acute Kidney Injury in Children after Hematopoietic Cell Transplantation Is Associated with Elevated Urine CXCL10 and CXCL9.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020Observational
- Clinical significance of PI3 and HLA-DOB as potential prognostic predicators for ovarian cancer.Translational cancer research · 2020Article
- IL-27 Promotes Human Placenta-Derived Mesenchymal Stromal Cell Ability To Induce the Generation of CD4Journal of immunology (Baltimore, Md. : 1950) · 2019Article
- Mini-review of kidney disease following hematopoietic stem cell transplant .Clinical nephrology · 2018Review
- Acute kidney injury in HCT: an update.Bone marrow transplantation · 2016Review
- Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review.International journal of nephrology · 2016Review
- NIH Consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. The 2014 Pathology Working Group Report.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2015Article
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectivesGraft-versus-host disease (GVHD) is associated with kidney injury after hematopoietic cell transplantation (HCT). Because plasma elafin levels correlate with skin GVHD, this study examined urinary elafin as a potential marker of renal inflammation and injury. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Urine was collected prospectively on 205 patients undergoing their first HCT from 2003 to 2010. Collections were done at baseline, weekly through day 100, and monthly through year 1 to measure elafin and urine albumin-to-creatinine ratio (ACR). Associations between urinary elafin levels and microalbuminuria, macroalbuminuria, AKI and CKD, and mortality were examined using Cox proportional hazards or linear regression models. Available kidney biopsy specimens were processed for immunohistochemistry.
resultsMean urinary elafin levels to day 100 were higher in patients with micro- or macroalbuminuria (adjusted mean difference, 529 pg/ml; P=0.03) at day 100 than in those with a normal ACR (adjusted mean difference, 1295 pg/ml; P<0.001). Mean urinary elafin levels were higher in patients with AKI compared with patients without AKI (adjusted mean difference, 558 pg/ml; P<0.01). The average urinary elafin levels within the first 100 days after HCT were higher in patients who developed CKD at 1 year than in patients without CKD (adjusted mean difference, 894 pg/ml; P=0.002). Among allogeneic recipients, a higher proportion of patients with micro- or macroalbuminuria at day 100 also had grade II-IV acute GVHD (80% and 86%, respectively) compared with patients with a normal ACR (58%; global P<0.01). Each increase in elafin of 500 pg/ml resulted in a 10% increase in risk of persistent macroalbuminuria (hazard ratio, 1.10; 95% confidence interval [95% CI], 1.06 to 1.13; P<0.001) and a 7% increase in the risk of overall mortality (95% CI, 1.02 to 1.13, P<0.01). Renal biopsy specimens from a separate cohort of HCT survivors demonstrated elafin staining in distal and collecting duct tubules.
conclusionHigher urinary elafin levels are associated with an increased risk of micro- and macroalbuminuria, AKI and CKD, and death after HCT.
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