Soluble urokinase receptor and mortality in kidney transplant recipients

A recent study by Heidelberg University Hospital explored how well suPAR predicts cardiovascular events and mortality in kidney transplant recipients. Researchers examined the link between suPAR levels measured before or one year post-transplant and outcomes in 1,023 patients.

Conclusion

A high suPAR level before and one year after kidney transplantation increases the risk of patient death, regardless of kidney function, mainly due to cardiovascular causes.

Methods

Serum suPAR levels in a total of 1,023 kidney transplant recipients either before (cohort 1, n = 474) or at year 1 after transplantation (cohort 2, n = 549) were measured. The association of suPAR levels and all-cause and cardiovascular mortality was evaluated by multivariable Cox regression analysis.

Results

The highest suPAR tertile compared to the two lower tertiles had a significantly higher risk of all-cause mortality in both cohorts separately (cohort 1: hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.20–3.08, p = 0.007; cohort 2: HR = 2.78, 95% CI 1.51–5.13, p = 0.001) and combined (n = 1,023, combined HR = 2.14, 95% CI 1.48–3.08, p < 0.001). The association remained significant in the subgroup of patients with normal kidney function (cohort 2: HR = 5.40, 95% CI 1.42–20.5, p = 0.013). The increased mortality risk in patients with high suPAR levels was attributable mainly to an increased rate of cardiovascular death (n = 1,023, HR = 4.24, 95% CI 1.81–9.96, p < 0.001).