Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.

Chronic renal allograft injury (CRAI) is a major cause of allograft loss in kidney transplant recipients (KTRs). The aim of this study was to evaluate the associations of urinary apolipoprotein A4 (ApoA-IV) levels with renal function and rapid renal function decline in KTRs. This study included 50 K...

Full description

Saved in:
Bibliographic Details
Main Authors: Youn Kyung Kee, Dong Ho Shin, Jieun Oh, Ji Young Park, Dong Hyun Kim, Kyungjai Ko, Samuel Lee, Hee Jung Jeon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0324529
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849309908778876928
author Youn Kyung Kee
Dong Ho Shin
Jieun Oh
Ji Young Park
Dong Hyun Kim
Kyungjai Ko
Samuel Lee
Hee Jung Jeon
author_facet Youn Kyung Kee
Dong Ho Shin
Jieun Oh
Ji Young Park
Dong Hyun Kim
Kyungjai Ko
Samuel Lee
Hee Jung Jeon
author_sort Youn Kyung Kee
collection DOAJ
description Chronic renal allograft injury (CRAI) is a major cause of allograft loss in kidney transplant recipients (KTRs). The aim of this study was to evaluate the associations of urinary apolipoprotein A4 (ApoA-IV) levels with renal function and rapid renal function decline in KTRs. This study included 50 KTRs. Proteomic analysis via liquid chromatography‒mass spectrometry and tandem mass spectrometry (LC-MS/MS) was performed to identify potential urinary biomarkers. The SWATH (sequential window acquisition of all theoretical mass spectra) method was used for protein quantification. Urinary ApoA-IV levels were validated by enzyme-linked immunosorbent assay (ELISA). Rapid renal function decline was defined as an estimated glomerular filtration rate (GFR) decrease of >3 mL/min/1.73 m2 per year or initiation of dialysis. The log-transformed urinary ApoA-IV levels measured by ELISA had a significantly inverse correlation with the estimated GFR (r = -0.72, P < 0.001). Moreover, urinary ApoA-IV levels were higher in patients with rapid renal function decline than in those with stable renal function (215.4 ± 181.8 μg/mL vs. 42.5 ± 72.4 μg/mL, P = 0.001). Univariate logistic regression analysis revealed that log-transformed urinary ApoA-IV levels were significantly associated with rapid renal function decline (odds ratio [OR] 6.70, 95% confidence interval [CI] 2.56-22.83; P < 0.001). Multiple logistic regression showed urinary ApoA-IV levels remained a significant risk factor for rapid renal function decline (OR 4.10, 95% CI 1.10-19.55; P = 0.047). ROC curve analysis revealed the area under the curve (AUC) of 0.834 (95% CI 0.722-0.945, P < 0.001) for urinary ApoA-IV levels in predicting rapid renal function decline. Our results suggest that urinary ApoA-IV levels might be a potential biomarker for renal allograft function and could be used as a predictor for rapid renal function decline in KTRs.
format Article
id doaj-art-690fa9844e9d4cafb21cc72fa70ca916
institution Kabale University
issn 1932-6203
language English
publishDate 2025-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-690fa9844e9d4cafb21cc72fa70ca9162025-08-20T03:53:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01205e032452910.1371/journal.pone.0324529Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.Youn Kyung KeeDong Ho ShinJieun OhJi Young ParkDong Hyun KimKyungjai KoSamuel LeeHee Jung JeonChronic renal allograft injury (CRAI) is a major cause of allograft loss in kidney transplant recipients (KTRs). The aim of this study was to evaluate the associations of urinary apolipoprotein A4 (ApoA-IV) levels with renal function and rapid renal function decline in KTRs. This study included 50 KTRs. Proteomic analysis via liquid chromatography‒mass spectrometry and tandem mass spectrometry (LC-MS/MS) was performed to identify potential urinary biomarkers. The SWATH (sequential window acquisition of all theoretical mass spectra) method was used for protein quantification. Urinary ApoA-IV levels were validated by enzyme-linked immunosorbent assay (ELISA). Rapid renal function decline was defined as an estimated glomerular filtration rate (GFR) decrease of >3 mL/min/1.73 m2 per year or initiation of dialysis. The log-transformed urinary ApoA-IV levels measured by ELISA had a significantly inverse correlation with the estimated GFR (r = -0.72, P < 0.001). Moreover, urinary ApoA-IV levels were higher in patients with rapid renal function decline than in those with stable renal function (215.4 ± 181.8 μg/mL vs. 42.5 ± 72.4 μg/mL, P = 0.001). Univariate logistic regression analysis revealed that log-transformed urinary ApoA-IV levels were significantly associated with rapid renal function decline (odds ratio [OR] 6.70, 95% confidence interval [CI] 2.56-22.83; P < 0.001). Multiple logistic regression showed urinary ApoA-IV levels remained a significant risk factor for rapid renal function decline (OR 4.10, 95% CI 1.10-19.55; P = 0.047). ROC curve analysis revealed the area under the curve (AUC) of 0.834 (95% CI 0.722-0.945, P < 0.001) for urinary ApoA-IV levels in predicting rapid renal function decline. Our results suggest that urinary ApoA-IV levels might be a potential biomarker for renal allograft function and could be used as a predictor for rapid renal function decline in KTRs.https://doi.org/10.1371/journal.pone.0324529
spellingShingle Youn Kyung Kee
Dong Ho Shin
Jieun Oh
Ji Young Park
Dong Hyun Kim
Kyungjai Ko
Samuel Lee
Hee Jung Jeon
Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
PLoS ONE
title Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
title_full Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
title_fullStr Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
title_full_unstemmed Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
title_short Urinary apolipoprotein A4 as a biomarker for renal allograft injury in kidney transplant recipients.
title_sort urinary apolipoprotein a4 as a biomarker for renal allograft injury in kidney transplant recipients
url https://doi.org/10.1371/journal.pone.0324529
work_keys_str_mv AT younkyungkee urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT donghoshin urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT jieunoh urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT jiyoungpark urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT donghyunkim urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT kyungjaiko urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT samuellee urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients
AT heejungjeon urinaryapolipoproteina4asabiomarkerforrenalallograftinjuryinkidneytransplantrecipients