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Am J Nephrol. 2011;33(5):407-13. doi: 10.1159/000326753. Epub 2011 Apr 15.

Urine cystatin C as a biomarker of proximal tubular function immediately after kidney transplantation.

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  • 1Department of Medicine, Section of Nephrology, Yale University School of Medicine and the Clinical Epidemiology Research Center, VAMC, New Haven, CT 06516, USA.



Clinical methods to predict allograft function soon after kidney transplantation are ineffective.


We analyzed urine cystatin C (CyC) in a prospective multicenter observational cohort study of deceased-donor kidney transplants to determine its peritransplant excretion pattern, utility for predicting delayed graft function (DGF) and association with 3-month graft function. Serial urine samples were collected for 2 days following transplant and analyzed blindly for CyC. We defined DGF as any hemodialysis in the first week after transplant, slow graft function (SGF) as a serum creatinine reduction < 70% by the first week and immediate graft function (IGF) as a reduction ≥ 70%.


Of 91 recipients, 33 had DGF, 34 had SGF and 24 had IGF. Urine CyC/urine creatinine was highest in DGF for all time-points. The area under the curve (95% CI) for predicting DGF at 6 h was 0.69 (0.57-0.81) for urine CyC, 0.74 (0.62-0.86) for urine CyC/urine creatinine and 0.60 (0.45-0.75) for percent change in urine CyC. On the first postoperative day, urine CyC/urine creatinine and percent change in urine CyC were associated with 3-month graft function.


Urine CyC on the day after transplant differs between degrees of perioperative graft function and modestly corresponds with 3-month function.

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