Pre-Transplant Angiotensin II Type 1 Receptor Antibodies: A Risk Factor for Decreased Kidney Graft Function at 12 Months Posttransplant?

Hernández-Méndez, Erick Alejandro; Arreola, José; Ramírez, J.; Calleja, Said; Castelán, Natalia; Salcedo, Maite; Vilatobá, Mario; Contreras, Angélica; Gabilondo, Bernardo; Granados, Jesús Benítez; Buenrostro, Morales L.; Alberú, Josefina

doi:10.1097/00007890-201407151-02137

Cited by 7 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This cutoff for anti-AT1R antibody levels was recently also observed by Lee et al [16], who showed in a multicenter observational Korean cohort with 166 consecutive kidney recipients that a titer of AT1R-Abs >9.05 U/ml was significantly associated with three times higher risk of biopsy-proven rejection but was not associated with a graft failure. Hernandez-Mendez et al [40] have shown that pretransplant AT1R-Abs was associated with a lower eGFR (estimated glomerular filtration rate) at 12 months post-transplantation, but there was no significant difference for biopsy-proven acute rejection in the AT1R-Ab-positive group. A recent meta-analysis found a significant effect of AT1R-Abs on the allograft outcome, without considering neither the threshold of AT1R-Ab positivity nor the HLA-Ab detection technology.…”

Section: Discussionmentioning

confidence: 98%

“…Hernandez‐Mendez et al . have shown that pretransplant AT1R‐Abs was associated with a lower eGFR (estimated glomerular filtration rate) at 12 months post‐transplantation, but there was no significant difference for biopsy‐proven acute rejection in the AT1R‐Ab‐positive group. A recent meta‐analysis found a significant effect of AT1R‐Abs on the allograft outcome, without considering neither the threshold of AT1R‐Ab positivity nor the HLA‐Ab detection technology.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is pre-transplant sensitization against angiotensin II type 1 receptor still a risk factor of graft and patient outcome in kidney transplantation in the anti-HLA Luminex era? A retrospective study

Deltombe

Gillaizeau

et al. 2017

Transpl Int

View full text Add to dashboard Cite

We aimed to assess the correlation of anti-angiotensin II type 1 receptor antibodies (anti-AT1R-Abs) before transplantation on a multicentric cohort of kidney transplant recipients (2008-2012), under tacrolimus and mycophenolate mofetil (MMF), screened by Luminex technology for anti-HLA immunization. Anti-AT1R antibody levels were measured by ELISA in pretransplantation sera of 940 kidney recipients from three French centers of the DIVAT cohort. Multivariable Cox models estimated the association between pretransplant anti-angiotensin II type 1 receptor antibodies and time to acute rejection episodes (ARE) or time to graft failure. Within our cohort, 387 patients (41.2%) had pretransplant AT1R-Abs higher than 10 U/ml and only 8% (72/970) greater than 17 U/ml. The cumulative probability of clinically relevant (cr)-ARE was 22.5% at 1 year post-transplantation [95% CI (19.9-25.4%)]. The cumulative probability of graft failure and patient death were 10.6% [95% CI (8.4-13.3%)] and 5.7% [95% CI (4.0-8.1%)] at 3 years post-transplantation, respectively. Multivariate Cox models indicated that pretransplant anti-AT1R antibody levels higher than 10 U/ml were not significantly independently associated with higher risks of acute rejection episodes [HR = 1.04, 95% CI (0.80-1.35)] nor with risk of graft failure [HR = 0.86, 95% CI (0.56-1.33)]. Our study did not confirm an association between pretransplant anti-AT1R antibody levels and kidney transplant outcomes.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Is pre-transplant sensitization against angiotensin II type 1 receptor still a risk factor of graft and patient outcome in kidney transplantation in the anti-HLA Luminex era? A retrospective study

Deltombe

Gillaizeau

et al. 2017

Transpl Int

View full text Add to dashboard Cite

show abstract

“…19–24 Dragun and colleagues were the first to report the association of AT 1 R-Ab with acute AMR, endarteritis, and severe hypertension in kidney transplant recipients. 19 Since that time, AT 1 R-Ab has also been linked to AMR in the absence of hypertension, allograft loss, acute cellular rejection (ACR), and decreased renal function in patients without this classical presentation, 21–25 suggesting multiple clinical phenotypes exist for AT 1 R-Ab mediated allograft injury.…”

Section: Introductionmentioning

confidence: 99%

Angiotensin II Type 1 receptor antibodies are associated with inflammatory cytokines and poor clinical outcomes in pediatric kidney transplantation

Pearl

Zhang

Díaz

et al. 2018

Kidney International

View full text Add to dashboard Cite

Angiotensin II type 1 receptor (AT1R) antibody has been linked to poor allograft outcomes in adult kidney transplantation. However, its clinical consequences in children are unknown. To study this, we examined the relationship of AT1R antibody with clinical outcomes, biopsy findings, inflammatory cytokines, and HLA donor-specific antibodies (DSA) in a cohort of pediatric renal transplant recipients. Sixty-five patients were longitudinally monitored for AT1R antibody, HLA DSA, IL-8, TNF-α, IL-1β, IFN-γ, IL-17, and IL-6, renal dysfunction, hypertension, rejection, and allograft loss during the first two years post transplantation. AT1R antibody was positive in 38 of the 65 of children but was not associated with HLA DSA. AT1R antibody was associated with renal allograft loss (odds ratio of 13.1 [95% confidence interval 1.48-1728]), the presence of glomerulitis or arteritis, and significantly higher TNF-α, IL-1β, and IL-8 levels, but not rejection or hypertension. AT1R antibody was associated with significantly greater declines in eGFR in patients both with and without rejection. Furthermore, in patients without rejection, AT1R antibody was a significant risk factor for worsening eGFR over the two-year follow-up period. Thus, AT1R antibody is associated with vascular inflammation in the allograft, progressive decline in eGFR, and allograft loss. AT1R antibody and inflammatory cytokines may identify those at risk for renal vascular inflammation and lead to early biopsy and intervention in pediatric kidney transplantation.

show abstract

“…After excluding duplicates, the titles and abstracts from the remaining 99 records were screened. Of these, 21 articles were selected for full text review, and nine articles were ultimately retained in our meta-analysis (see Figure 1 ) [ 12 , 13 , 14 , 15 , 16 , 21 , 22 , 23 , 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, AR after kidney allograft transplantation frequently progresses to persistent chronic rejection and dysfunction of kidney allograft, and ultimately results in kidney graft failure [ 11 ], indicating that AT1R-Abs may also influence the long-term outcomes of kidney allograft transplantation. Currently, several studies have shown that AT1R-Abs might be associated with an increased risk of acute rejection and kidney graft failure [ 12 , 13 , 14 ]; however, the results are inconsistent and inconclusive [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Presence of Anti-Angiotensin II Type-1 Receptor Antibodies Adversely Affect Kidney Graft Outcomes

Zhang

Wang

Liang

et al. 2017

IJERPH

View full text Add to dashboard Cite

The aim of this study was to determine whether anti-angiotensin type 1 receptor antibodies (AT1R-Abs) are related to acute rejection (AR) and kidney graft failure in renal transplantation. We searched electronic databases including MEDLINE, EMBASE, and the ISI Web of Science databases for all studies on the association between anti-angiotensin type 1 receptor antibodies and kidney allograft outcomes updated to November 2016. Reference lists from included articles were also reviewed. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were extracted or calculated using a random-effects model. The potential sources of heterogeneity and publication bias were estimated. Nine studies enrolling 1771 subjects were retrieved in the meta-analysis. AT1R-Abs showed significant associations with increased risk of AR (RR = 1.66; 95% CI, 1.23–2.09). In addition, a significant relationship was found between AT1R-Abs and kidney graft failure compared with AR (RR = 3.02; 95% CI, 1.77–4.26). The results were essentially consistent among subgroups stratified by participant characteristics. These results demonstrated that the AT1R-Abs were associated with an elevated risk of kidney allograft outcomes, especially with kidney graft failure. Large-scale studies are still required to further verify these findings.

show abstract

Pre-Transplant Angiotensin II Type 1 Receptor Antibodies: A Risk Factor for Decreased Kidney Graft Function at 12 Months Posttransplant?

Cited by 7 publications

References 0 publications

Is pre-transplant sensitization against angiotensin II type 1 receptor still a risk factor of graft and patient outcome in kidney transplantation in the anti-HLA Luminex era? A retrospective study

Is pre-transplant sensitization against angiotensin II type 1 receptor still a risk factor of graft and patient outcome in kidney transplantation in the anti-HLA Luminex era? A retrospective study

Angiotensin II Type 1 receptor antibodies are associated with inflammatory cytokines and poor clinical outcomes in pediatric kidney transplantation

The Presence of Anti-Angiotensin II Type-1 Receptor Antibodies Adversely Affect Kidney Graft Outcomes

Contact Info

Product

Resources

About