Abstract
There are reports on the effects of excessive recipient body weight on renal graft function. Increased CCL2 (chemokine CC-mortif ligand 2) production is observed in patients with excessive body weight. CCL2 also exacerbates the inflammatory process in the renal graft. A total of 49 renal graft recipients of both sexes having undergone renal biopsy within the last 18 months were retrospectively reviewed. At their most recent appointment the patients’ plasma concentrations of CCL2 were evaluated. Renal function was assessed retrospectively. CCL2 concentrations were higher in men than women (p < 0.047), while higher CCL2 levels were associated with a decrease in eGFR (estimated glomerular filtration rate) during the first year post Tx (kidney transplantation). CCL2 negatively correlated with eGFR at 5 years (R = −0.45, p < 0.040997) and positively correlated with the degree of tubular atrophy in renal biopsy specimens (R = 0.43, p < 0.027293) and with systolic pressure. Men showed significantly higher BMI (body mass index) values at the time of Tx and at their last appointment than women did (p < 0.000403; p < 0.000613, respectively). Men showed poorer long-term renal graft function, with significantly lower eGFR values at 4 and 5 years into the post-transplantation period. The male sex and excessive body weight have adverse effects on short- and long-term renal graft function, which is associated with increased levels of CCL2.
Highlights
Kidney transplantation (Tx) is the best acknowledged renal replacement therapy [1].The treatment of patients in the initial post-transplantation period is well controlled due to the availability of new immunosuppressive drugs, improved surgical techniques and better perioperative care [2]
CCL2 concentrations correlated negatively with eGFR at 5 years (R = −0.45, p < 0.040997), positively with the degree of Interstitial fibrosis and tubular atrophy (IF/tubular atrophy (TA)) determined in renal biopsy specimens (R = 0.43, p < 0.027293) and positively with systolic pressure
Higher CCL2 concentrations were found in patients with post-transplantation diabetes mellitus, no statistical significance (p = 0.08) was reached, which may have resulted from the small size of the study group
Summary
Kidney transplantation (Tx) is the best acknowledged renal replacement therapy [1].The treatment of patients in the initial post-transplantation period is well controlled due to the availability of new immunosuppressive drugs, improved surgical techniques and better perioperative care [2]. Interstitial fibrosis and tubular atrophy (IF/TA) found in renal biopsy specimens is one of the main causes of progressive renal graft dysfunction and is responsible for approximately 30% of its cases [3]. It is believed that IRI may be associated with delayed renal graft function and poorer graft function in the short- and long-term follow-up period after Tx [3,4]. This is linked to the activation of oxidative stress, the generation of reactive oxygen species and neutrophil recruitment [4]
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