Abstract
Introduction: There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk. Objectives: This study is designed to measure circulating uromodulin levels and explore their relationship to urinary tract infection and renal function in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated 6–12 months of post-transplantation. Fasting blood samples were taken to determine the serum level of uromodulin with urea, creatinine, and other biochemical characteristics. Urine samples were taken for analysis and culture. Kidney function was estimated based on the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine equation and the modification of diet in renal disease (MDRD) equation. Results: Patients’ serum uromodulin levels were significantly correlated with their serum creatinine (P = 0.024) and estimated glomerular filtration rate by the EPI equation (eGFR-EPI, P = 0.038). There was no significant association between serum uromodulin levels and incidence of urinary tract infection of post-transplantation (P > 0.05). Conclusion: Serum and urine uromodulin levels may be regarded as the predictive indicators of renal function. However, given the lack of studies on the association between serum uromodulin levels and urinary tract infection risks in kidney transplant recipients, further research is needed to clarify uromodulin’s protective effect against urinary tract infection.
Highlights
There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk
Implication for health policy/practice/research/medical education: In a study on 90 eligible kidney transplant recipients, we found serum uromodulin levels are significantly related to serum creatinine levels and estimated glomerular filtration rate, but there is no significant association between serum uromodulin levels and urinary tract infection incidence
Based on the results of epidemiological studies, urinary uromodulin appears to have a direct correlation with kidney size and renal function as measured by glomerular filtration rate (GFR), and has a reverse association with increasing the age and diabetes [1,10]
Summary
There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk. Uromodulin, known as the Tamm-Horsfall protein, is a glycoprotein produced by the thick ascending limb of the loop of Henle and the early distal convoluted tubule [1, 2] It is the most abundantly excreted protein in the urine of healthy adults and plays several important roles, including the prevention of renal stones, the regulation of arterial blood pressure, and the prevention of urinary tract infection by binding and inhibiting bacterial adhesion to the uroepithelium [3,4,5,6,7,8,9]. Based on the results of epidemiological studies, urinary uromodulin appears to have a direct correlation with kidney size and renal function as measured by glomerular filtration rate (GFR), and has a reverse association with increasing the age (over 60 years) and diabetes [1,10]. Urinary tract infection affects about 5%–36% of kidney transplant recipients, while both are the most prevalent infectious disease in this group and may lead to reduced kidney function [13,14]
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