KOSIN UNIVERSITY COLLEGE OF MEDICINE
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- Clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients
- Yoo Jin Lee, Chang Min Heo, Sihyung Park, Il Hwan Kim, Jin Han Park, Junghae Ko, Bong Soo Park, Yang Wook Kim
- Kosin Med J. 2022;37(3):220-227. Published online September 2, 2022
- DOI: https://doi.org/10.7180/kmj.22.107
- 1,024 View
- 21 Download
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Abstract
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- Background
Copeptin is the carboxyl-terminal part of the vasopressin precursor protein, and its concentration is an independent predictor of the onset of chronic kidney disease and a rapid decline in the glomerular filtration rate. The glomerular filtration rate is regarded as the best indicator of kidney transplant function and is a predictor of graft and patient survival. We investigated the clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients.
Methods
We measured serum creatinine, cystatin C, and copeptin concentrations in renal transplant recipients on the day of their operation, as well as on postoperative days 3, 7, 30, and 365. Acute rejection was defined as a sudden decrease in renal function accompanied by histological changes.
Results
Eight renal transplant recipients were enrolled in the study from July 2018 to December 2019. Four patients experienced histologically confirmed transplant rejection. All four cases involved acute T-cell rejection. No significant correlation was found between the copeptin level and the presence or absence of rejection at any time point. In subgroup analyses, changes in creatinine, the estimated glomerular filtration rate, cystatin, and copeptin did not show statistical significance.
Conclusions
We anticipated that copeptin would be useful to identify individuals at high risk of transplant rejection; however, our study failed to show an association. Further research will be needed to overcome the limitations of this study.
- A study of the effectiveness of using the serum procalcitonin level as a predictive test for bacteremia in acute pyelonephritis
- Ga Hee Lee, Yoo Jin Lee, Yang Wook Kim, Sihyung Park, Jinhan Park, Kang Min Park, Kyubok Jin, Bong Soo Park
- Kosin Med J. 2018;33(3):337-346. Published online December 31, 2018
- DOI: https://doi.org/10.7180/kmj.2018.33.3.337
- 1,105 View
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Abstract
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Objectives Serum procalcitonin (PCT) is a specific biomarker that rises after bacterial infection, and levels of PCT are known to correlate with the severity and mortality of patients with pneumonia and sepsis. However, the usefulness of PCT levels in acute pyelonephritis is unknown. This study aimed to evaluate the effectiveness of using the PCT level as a predictive test for bacteremia in acute pyelonephritis.
Methods Between January 2012 and June 2013, 140 patients diagnosed with acute pyelonephritis were admitted to Haeundae Paik Hospital. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) levels at pre- and post- treatment were measured. Blood and urine cultures were obtained from all patients. The levels of PCT, CRP, and WBCs were each compared between the blood culture-positive and blood culture-negative groups to assess their effectiveness in predicting bacteremia.
Results Pre-treatment PCT level was 0.77 ng/mL (95% CI: 0.42–1.60 ng/mL) in the blood culture-negative group and 4.89 ng/mL (95% CI: 2.88–9.04 ng/mL) in the blood culture-positive group, and the increase between the two groups was statistically significant. The area under the receiver operating characteristic curve of PCT level for prediction of bacteremia was 0.728. A cut-off value of 1.23 ng/mL indicated a sensitivity of 79.0 % and specificity of 60.0 % for PCT level.
Conclusions Serum PCT level is a useful predictive test for bacteremia in acute pyelonephritis. Through the early detection of bacteremia, serum PCT level can help estimate the prognosis and predict complications such as sepsis.
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