Kidney Transplant Rejection May Be Predicted By Urine Test

Doctors may be able to tell if a kidney patient is rejecting a donor organ, or possibly predict rejection prior to its occurrence through an experimental urine test.  This test was developed by researchers when they found three bio markers in urine that allows them to diagnose organ rejection in 485 kidney transplant patients.  These markers can also determine which patients have a high risk of rejection.  This rejection, called acute cellular rejection, is usually diagnosed once the potential signs and symptoms have already appeared.  This traditional diagnosis, a kidney biopsy, is also invasive.

Generally, kidney biopsies are safe, but they can involve pain and bleeding.  Additionally, biopsies cannot be done on a regular basis in order to attempt to catch kidney rejection early, prior to damage to the organ.  A urine test however, is less invasive and could be used to catch kidney rejection before damage is caused to the organ.  This new approach still need more work in order to make it useful in practice, outside of the research setting.

This study had 485 donor-kidney recipients who had samples of urine collected at regular intervals over the course of one year after the transplant.  During this year, 220 of the patients had a kidney biopsy and 36 were diagnosed as having acute cellular rejection.  It was discovered by the researchers that when three biomarkers were measured in the urine, biopsy-diagnosed episodes of kidney rejection were distinguishable 79 percent of the time.

These results show that the test has the potential to spot patients who have a high risk of rejection.  Identifying these patients would allow doctors to increase the patient’s dose of immune-system-suppressing medication.  This could hopefully stop an acute rejection of the kidney prior to any damage being done to the donated organ.  On the other side, if a transplant patient’s urinary biomarkers hold steady, they may be able to have a lower dose of anti-rejection medication, reducing immunosuppressive therapy in some patients.

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