Fig 1.
Characteristics of the recipients.
CNI, calcineurin inhibitor; TAC, tacrolimus; uNGAL, urinary neutrophil gelatinase–associated lipocalin; Δ, change.
Fig 2.
Comparison of renal injury markers before (D 0) and 3 days after (D +3) TAC dose adjustment in the -ΔTACdose and +ΔTACdose groups.
SCr and the alteration in SCr from the baseline were comparable between recipients in the decreased TAC dose (-ΔTACdose) and increased TAC dose (+ΔTACdose) groups (A and B). There were no differences in uNGAL and uNGAL/uCr between the -ΔTACdose and +ΔTACdose groups (C, E) but the alteration in absolute uNGAL (ΔuNGAL) and uNGAL/uCr from the baseline were higher in the +ΔTACdose group (D, F).
Fig 3.
Comparison of urinary cytokines between the day before (D 0) and 3 days after (D +3) TAC dose adjustment in the -ΔTACdose and +ΔTACdose groups.
Both urinary IL-18 (A) and IL-6 (B) but not TNF-α were higher in recipients with increased TAC doses after dose adjustment.
Fig 4.
Renal allograft histology, change in eGFR and percentage change in 24-h proteinuria during the study period.
A scatter plot showing eGFR and the percentage alteration in mean values of eGFR in the -ΔTACdose and +ΔTACdose groups at enrolment versus the values observed 12 months post-enrolment (A). The time course of changes in eGFR in all four subgroups (B, left side) (B, right side), in addition to the percentage change in 24-h urinary protein, in each group (C) *(p < 0.01), ***(p < 0.001).
Table 1.
Baseline demographics.
Table 2.
Changes in chronic biopsy scores in kidney allografts with time post-KT.
Fig 5.
Urinary NGAL was predictive of chronic renal allograft fibrosis at 12 months post-enrolment.
Kaplan–Meier curve for the association of chronic renal allograft fibrosis with uNGAL (A) and ROC curve for the association between uNGAL at enrolment and chronic renal allograft fibrosis (B) were demonstrated.
Table 3.
Determinants of renal allograft interstitial fibrosis and tubular atrophy at the time of enrolment using univariate and multivariate Cox proportional hazards model.
Table 4.
Median urinary NGAL levels stratified by status of renal allograft function.