Table 3.
Association of Urine Fibrosis Markers With Risk for Kidney Allograft Failure in FAVORIT
| No. of Events | Event Rate, per 100 PY | Model 1 | Model 2 | Model 3 | Model 4 | |
|---|---|---|---|---|---|---|
| Urine AIM | ||||||
| Per log2 increase | 2.13 (1.79–2.53); | 1.73 (1.43–2.08); | 1.51 (1.12–2.04); | 1.76 (1.27–2.44); | ||
| P < 0.001 | P < 0.001 | P = 0.008 | P = 0.001 | |||
| Q1: <0.79 mg/L | 30 | 0.83 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Q2: 0.79–1.60 mg/L | 45 | 1.74 | 2.51 (1.17–5.35) | 2.81 (1.24–6.35) | 2.71 (1.41–6.44) | 4.23 (1.56. 11.42) |
| Q3: 1.61–3.78 mg/L | 76 | 2.19 | 6.79 (3.29–14.01) | 5.64 (2.53–12.61) | 4.07 (1.66–9.95) | 7.62 (2.57–22.57) |
| Q4: ≥3.79 mg/L | 104 | 2.96 | 13.49 (6.27–29.0) | 7.36 (3.21–16.89) | 3.15 (1.07–9.27) | 6.14 (1.75–21.55) |
| Urine MCP-1 | ||||||
| Per log2 increase | 2.03 (1.68–2.44); | 1.60 (1.32–1.93); | 1.47 (1.16–1.85); | 1.49 (1.17–1.89); | ||
| P < 0.001 | P < 0.001 | P = 0.001 | P = 0.001 | |||
| Q1: <84.2 pg/mL | 42 | 1.70 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Q2: 84.2–183.3 pg/mL | 58 | 1.39 | 1.99 (1.02–3.86) | 1.60 (0.78–3.30) | 1.12 (0.51–2.44) | 1.33 (0.59–3.01) |
| Q3: 183.4–351.4 pg/mL | 65 | 1.78 | 4.22 (2.09–8.52) | 2.80 (1.35–5.79) | 1.55 (0.66–3.63) | 1.89 (0.79–4.53) |
| Q4: ≥351.4 pg/mL | 88 | 3.00 | 7.57 (3.55–16.13) | 4.59 (2.10–10.05) | 2.00 (0.81–4.95) | 2.13 (0.83–5.44) |
| Urine PIIINP | ||||||
| Per log2 increase | 1.28 (1.10–1.49); | 1.12 (0.97–1.30); | 0.91 (0.78–1.06); | 0.76 (0.64–0.90); | ||
| P = 0.001 | P = 0.1 | P = 0.2 | P = 0.001 | |||
| Q1: <2.09 mg/L | 57 | 1.48 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Q2: 2.09–3.63 mg/L | 51 | 1.50 | 1.04 (0.58–1.85) | 1.03 (0.54–1.97) | 0.58 (0.30–1.12) | 0.34 (0.17–0.68) |
| Q3: 3.64–6.15 mg/L | 74 | 2.56 | 1.91 (1.09–3.35) | 1.41 (0.79–2.53) | 0.53 (0.27–1.04) | 0.19 (0.09–0.41) |
| Q4: ≥6.16 mg/L | 75 | 2.41 | 1.99 (1.08–3.68) | 0.94 (0.47–1.87) | 0.17 (0.07–0.38) | 0.04 (0.02–0.11) |
| Urine PINP | ||||||
| Per log2 increase | 1.27 (1.13–1.44); | 1.12 (0.99–1.27); | 1.00 (0.88–1.14); | 0.99 (0.87–1.14); | ||
| P < 0.001 | P = 0.07 | P = 0.9 | P = 0.9 | |||
| Q1: <1.25 mg/L | 57 | 1.13 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Q2: 1.25–2.36 mg/L | 51 | 1.85 | 1.21 (0.69–2.12) | 1.38 (0.77–2.47) | 1.23 (0.68–2.23) | 1.22 (0.67–2.21) |
| Q3 2.37–3.83 mg/L | 57 | 1.37 | 1.27 (0.70–2.31) | 0.99 (0.51–1.91) | 0.67 (0.34–1.33) | 0.61 (0.30–1.22) |
| Q4: ≥3.84 mg/L | 92 | 3.74 | 3.77 (2.12–6.71) | 1.76 (0.92–3.36) | 0.79 (0.39–1.62) | 0.60 (0.28–1.29) |
Unless otherwise indicated, values are given as hazard ratio (95% confidence interval). Events refer to kidney allograft failure events. Model 1: adjusted for urine creatinine, age, sex, race, country, randomized treatment, diabetes, systolic blood pressure, cardiovascular disease, smoking, time since transplantation, and living donor. Model 2: model 1 plus estimated glomerular filtration rate and urine albumin. Model 3: model 2 plus NGAL, IL-18, KIM-1, and L-FABP. Model 4: model 3 plus urine PIIINP, PINP, AIM, and MCP-1.
Abbreviations: A1M, α1-microglobulin; FAVORIT, Folic Acid for Vascular Outcome Reduction in Transplantation; IL-18, interleukin 18; KIM-1, kidney injury molecule 1; L-FABP, liver-type fatty acid binding protein; MCP-1, monocyte chemoattractant protein 1; NGAL, neutrophil gelatinase-associated lipocalin; PINP, procollagen type I; PIIINP, procollagen type III; PY, patient-year; Q, quartile.