Abstract
The burden of chronic kidney disease is dramatically rising, making it a major public health concern worldwide. Kidney transplantation is now the best treatment for patients with end-stage renal disease. Although kidney transplantation may improve survival and quality of life, its long-term results are hampered by immune- and/or non-immune-mediated complications. Thus, the identification of transplanted patients with a higher risk of posttransplant complications has become a big challenge for public health. However, current biomarkers of posttransplant complications have a poor predictive value, rising the need to explore novel approaches for the management of transplant patient. In this review we summarize the emerging literature about DNA methylation in kidney transplant complications, in order to highlight its perspectives toward biomarker identification. In the forthcoming future the monitoring of DNA methylation in kidney transplant patients could become a plausible strategy toward the prevention and/or treatment of kidney transplant complications.
Highlights
The burden of chronic kidney disease (CKD), in terms of human suffering and economic costs, is dramatically rising, making it a major public health concern worldwide [1]
In the forthcoming future the monitoring of DNA methylation in kidney transplant patients could become a plausible strategy toward the prevention and/or treatment of kidney transplant complications
Kidney transplantation currently remains the best replacement therapy for patients with irreversible end-stage renal disease (ESRD) [4], since it is associated with improved survival and quality of life compared to hemodialysis [5], but either immuneor non-immune-mediated complications significantly contribute to the higher morbidity of transplant patients [5]
Summary
The burden of chronic kidney disease (CKD), in terms of human suffering and economic costs, is dramatically rising, making it a major public health concern worldwide [1]. Patients receiving renal replacement therapy are appraised at more than 1.4 million worldwide, with an estimated ≈8% increasing incidence each year [2]. Kidney transplantation currently remains the best replacement therapy for patients with irreversible ESRD [4], since it is associated with improved survival and quality of life compared to hemodialysis [5], but either immuneor non-immune-mediated complications significantly contribute to the higher morbidity of transplant patients [5]. Several factors may affect transplant outcomes, including donor age, alloimmune response, ischemia-reperfusion injury, interstitial fibrosis of the allograft, recipient comorbidity, degree of human leukocyte antigen mismatch and polymorphisms in immunologic and nonimmunologic genes [11,12,13,14]. We discuss the perspectives and the clinical usefulness of DNA methylation changes as biomarkers of kidney transplant complications
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