ArticleEBioMedicine2019
A urinary metabolite constellation to detect acute rejection in kidney allografts.
Article in EBioMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Urinary Biomarkers for Diagnosis and Prediction of Acute Kidney Allograft Rejection: A Systematic Review.International journal of molecular sciences · 2020Pooled it
- T-Cell Remodeling in Renal Fibrosis: From Acute Injury to Chronic Kidney Disease.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Diagnosis of early kidney allograft rejection: influencing factors in metabolite-based urine analysis.Frontiers in medicine · 2026Article
- Urinary metabolite signatures to detect and differentiate graft injury in kidney transplant patients.iScience · 2025Article
- Article
- An Exosomal mRNA Urine Test for Detection and Risk Stratification of Human Kidney Transplant Rejection.Kidney international reports · 2025Article
- Emerging Molecular Technology in Cancer Testing.EJIFCC · 2024Review
- Perspective: metabolomics has the potential to change the landscape of kidney transplantation diagnostics.Biomarkers in medicine · 2024Article
- Biomarkers for Kidney-Transplant Rejection: A Short Review Study.Biomedicines · 2023Review
- Characteristic Genes and Immune Infiltration Analysis for Acute Rejection after Kidney Transplantation.Disease markers · 2022Article
- Article
- A Prospective Multicenter Trial to Evaluate Urinary Metabolomics for Non-invasive Detection of Renal Allograft Rejection (PARASOL): Study Protocol and Patient Recruitment.Frontiers in medicine · 2021Article
- To accompany Banas et al., Time for a Paradigm Shift.EBioMedicine · 2019Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo validate a novel method for post-transplant surveillance to detect kidney allograft rejection via a characteristic constellation of the urine metabolites alanine, citrate, lactate, and urea investigated by nuclear magnetic resonance (NMR) spectroscopy a first prospective, observational study was performed.
methodsWithin the UMBRELLA study 986 urine specimens were collected from 109 consecutively enrolled renal transplant recipients, and metabolite constellations were analyzed. A metabolite rejection score was calculated and compared to histopathological results of corresponding indication and protocol allograft biopsies (n = 206).
findingsThe metabolite constellation was found to be a useful biomarker to non-invasively detect acute allograft rejection (AUC = 0.75; 95% confidence interval (CI) 0.68-0.83; based on 46 cases and 520 control samples). Combined analysis of the metabolite rejection score and the estimated glomerular filtration rate (eGFR) at the time of urine sampling further improved the overall test performance significantly (AUC = 0.84; 95% CI 0.76-0.91; based on 42 cases and 468 controls). Regarding the time course analysis in patients without rejection episodes the test results remained well below a diagnostic threshold associated with high risk of acute rejection. In other cases, a marked increase above this threshold indicated acute allograft rejection already six to ten days before diagnostic renal biopsies were performed.
interpretationA combination of an NMR-based urine metabolite analysis and eGFR is promising as a non-invasive test for post-transplant surveillance and to support decision making whether renal allografts need histopathological evaluation.
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