• Juan C Ramirez-Sandoval, Jonatan Barrera-Chimal, Perla E Simancas, Ricardo Correa-Rotter, Norma A Bobadilla, and Luis E Morales-Buenrostro.
• Department of Nephrology and Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, DF, Mexico.
• Nephrology (Carlton). 2014 Jun 1; 19 (6): 352-8.

AimTo evaluate the performance of urinary neutrophil gelatinase-associated lipocalin (uNGAL), kidney injury molecule, interleukin-18 and heat shock protein 72 for differential diagnosis between causes of acute kidney injury in kidney transplant recipients, especially immunological rejection.Patients And MethodsWe measured these biomarkers in 67 kidney transplant recipients with acute kidney injury according to the RIFLE criteria.ResultsThere were no statistical differences in biomarkers between kidney transplant recipients with immunological rejection (n = 20), pre-renal causes (n = 20) and other AKI causes (n = 27). Only the uNGAL level relative to urinary creatinine (uNGAL/uCr) for immunological rejection was different in comparison with others (P < 0.001); a cut-off of 59 μg/g of uNGAL/uCr had a sensitivity and specificity of 60% and 58% respectively (area under the curve in receiver-operating characteristic curve, 0.65). The other biomarkers were not useful in differentiating the causes of acute kidney injury.ConclusionThe biomarkers tested are not useful in identifying immunological rejection as cause of acute kidney injury in kidney transplant recipients.© 2014 Asian Pacific Society of Nephrology.

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