Soluble Urokinase Receptor and Mortality in Kidney Transplant Recipients

Christian Morath, Salim S. Hayek, Bernd Döhler, Christian Nusshag, Claudia Sommerer, Martin Zeier, Jochen Reiser, Caner Süsal

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Main problem: Soluble urokinase plasminogen activator receptor (suPAR) is an immunological risk factor for kidney disease and a prognostic marker for cardiovascular events. Methods: We measured serum suPAR levels in a total of 1,023 kidney transplant recipients either before (cohort 1, n = 474) or at year 1 after transplantation (cohort 2, n = 549). The association of suPAR levels and all-cause and cardiovascular mortality was evaluated by multivariable Cox regression analysis. Results: The highest suPAR tertile compared to the two lower tertiles had a significantly higher risk of all-cause mortality in both cohorts separately (cohort 1: hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.20–3.08, p = 0.007; cohort 2: HR = 2.78, 95% CI 1.51–5.13, p = 0.001) and combined (n = 1,023, combined HR = 2.14, 95% CI 1.48–3.08, p < 0.001). The association remained significant in the subgroup of patients with normal kidney function (cohort 2: HR = 5.40, 95% CI 1.42–20.5, p = 0.013). The increased mortality risk in patients with high suPAR levels was attributable mainly to an increased rate of cardiovascular death (n = 1,023, HR = 4.24, 95% CI 1.81–9.96, p < 0.001). Conclusion: A high suPAR level prior to and at 1 year after kidney transplantation was associated with an increased risk of patient death independent of kidney function, predominantly from cardiovascular cause.

Original languageEnglish (US)
Article number10071
JournalTransplant International
Volume35
DOIs
StatePublished - Feb 3 2022
Externally publishedYes

Keywords

  • cardiovascular
  • kidney
  • mortality
  • suPAR
  • transplantation

ASJC Scopus subject areas

  • Transplantation

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