Evaluation of Plasma and Urinary Tumor Necrosis Factor alpha Interleukin-2 Receptor and Interleukin-6 Levels in Renal Allograft Recepients

Jeon, Yong Sung; Ko, Jeong Ouk; Kwun, Woo Hyung; Huh, Young Soo; Suh, Bo Yang; Kwun, Koing Bo

Abstract

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.