Kidney Week

Abstract: TH-PO794

Urinary Podocin as a Noninvasive Marker of Kidney Injury in New-Onset Diabetes after Kidney Transplantation

Session Information

• Transplantation: Clinical - 2
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Rezende, Adriana Augusto de, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil

Adriana Augusto de Rezende

• Galdino, Ony Araujo, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil

Ony Araujo Galdino, MSc

• De Lima, Mabelle Alves Ferreira, Universidade Potiguar, Natal, Rio Grande do Norte, Brazil

Mabelle Alves Ferreira De Lima, MS

• Pereira, Mauricio Galvao, Universidade Potiguar, Natal, Rio Grande do Norte, Brazil

Mauricio Galvao Pereira, MD, PhD

• Almeida, Jose Bruno, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil

Jose Bruno Almeida, MD, PhD

• Ururahy, Marcela, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil

Marcela Ururahy, PharmD, PhD

• Souza, Karla, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil

Karla Souza, PharmD

Background

New-onset diabetes after transplantation (NODAT) is a serious metabolic complication that leads to decreased survival of renal allograft transplantation. However, currently, there is no early marker to assess kidney injury in NODAT. Given that podocytes are the primary targets of kidney injury, proteins from these cells are potential early markers of kidney dysfunction in NODAT. Among these podocyte proteins, podocin is an important molecule that maintains the integrity of the glomerular filtration barrier, which is negatively regulated in the case of kidney injury. Therefore, the aim of the study was to evaluate the potential of urinary podocin as a non-invasive marker of kidney injury in NODAT.

Methods

Thirty-eight kidney transplant (KTx) patients, who were 6 months post-KTx and aged above 19 years, without a history of segmental and focal glomerulosclerosis or Diabetes mellitus, were recruited. Patients were divided into 2 groups according to the diagnosis of NODAT [non-NODAT (n=20) and NODAT (n=18) groups]. Fasting blood glucose, glycated hemoglobin, serum creatinine, urinary albumin/creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR) were determined. Podocin was measured by western blot from urinary extracellular vesicles, previously isolated by ultracentrifugation. Podocin band density was normalized by urinary creatinine.

Results

An increase in fasting blood glucose (p < 0.001) and HbA1c levels (p < 0.001) was observed in the NODAT group. Additionally, ACR and serum creatinine levels were elevated in the NODAT group compared to the non-NODAT group (p < 0.001, for both). In contrast, eGFR values decreased in the NODAT group compared to the non-NODAT group (p = 0.003). Increased urinary podocin was found in the NODAT group compared to the non-NODAT group (p < 0.001). Furthermore, urinary podocin was observed to be a predictor of low eGFR <60 mL/min/1.73 m² [Area Under the Receiver Operating Characteristic (AUROC) = 0.844; p = 0.032].

Conclusion

This study is the pioneer to show an increase in urinary podocin in NODAT patients. These results associated with the ones obtained in the AUROC analysis and for the eGFR suggest that urinary podocin can become a potential marker in the early detection of kidney injury in the NODAT.

Funding

• Government Support – Non-U.S.