ESPN 50th Annual Meeting

ESPN 2017


 
PENTRAXIN-3 AND INFLAMMATORY STATUS IN PEDIATRIC RENAL TRANSPLANT RECIPIENTS
NUR CANPOLAT 1 CIGDEM ORUC 1 SEHA SAYGILI 1 HAKAN EKMEKCI 2 FATMA LALE SEVER 1 SALIM CALISKAN 1

1- ISTANBUL UNIVERSITY CERRAHPASA MEDICAL FACULTY, DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- ISTANBUL UNIVERSITY CERRAHPASA MEDICAL FACULTY, DEPARTMENT OF BIOCHEMISTRY
 
Introduction:

Chronic inflammation is mostly linked to chronic kidney disease (CKD) and is associated with progression of renal disease, cardiovascular disease and poor outcome. Renal transplantation (RTx) may improve this condition whereas it may also contribute to inflammation via oxidative stress due to ischemia reperfusion injury, acute rejection, graft dysfunction, hypertension and increased body mass index. In the present study, we evaluated inflammatory status in pediatric RTx recipients. 

Material and methods:

A total of 24 RTx patients (17 males, aged between 5.0-18.6 years) with a functioning kidney [median (IQR) of eGFR; 66.5 (27) ml/min/1.73m2] were enrolled in the single-center study. Control group consisted of 12 age, gender and eGFR similar patients with CKD. For the assessment of inflammatory status, Pentraxin-3, IL-6 and IL-10 were measured by ELISA method. Routine biochemical parameters and high sensitive (hs)-CRP were recorded from the patients’ file. 24-hour MAP was also recorded from the last ABPM within 6 months. Patients who had a 24-hour MAP≥2SDS were defined as hypertensive.

Results:

The median age at the transplantation was 11.8 (2.2-17.0) years and the median follow-up was 35.1 (3-87) months. All except one patient received their first graft and 19 (79%) received a kidney from a living donor.  Four patients (17%) had a history of acute rejection episodes. There was no difference considering inflammatory markers except Pentraxin-3 between the two groups. The median (IQR) of serum Pentraxin-3 levels was significantly lower in renal transplant recipients as compared to CKD controls [1.00 (0.99) vs. 1.51 (1.02) ng/mL, p=0.026) and it was positively correlated with 24h-MAP SDS (r=0.453, p=0.034) but not with any other clinical or laboratory parameters. Hypertensive patients (n=6) showed higher medians (IQR) of Pentraxin-3 [1.90 (1.12) vs. 0.86 (0.57) ng/mL, p=0.027] and lower IL-10 levels [6.42 (4.66) vs. 10.7 (10.8) pg/mL, p=0.040].

Conclusions:

Pentraxin-3, a marker of vascular inflammation is lower in RTx recipients compared to CKD patients, whereas a high level of pentraxine-3 is closely associated with hypertension.