Kosin Med J.  2022 Sep;37(3):220-227. 10.7180/kmj.22.107.

Clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients

• Lee YJ
• Heo CM
• Park S
• Kim IH
• Park JH
• Ko J
• Park BS
• Kim YW

• KMID: 2538801
• DOI: http://doi.org/10.7180/kmj.22.107

Abstract

Background
Copeptin is the carboxyl-terminal part of the vasopressin precursor protein, and its concentration is an independent predictor of the onset of chronic kidney disease and a rapid decline in the glomerular filtration rate. The glomerular filtration rate is regarded as the best indicator of kidney transplant function and is a predictor of graft and patient survival. We investigated the clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients.
Methods
We measured serum creatinine, cystatin C, and copeptin concentrations in renal transplant recipients on the day of their operation, as well as on postoperative days 3, 7, 30, and 365. Acute rejection was defined as a sudden decrease in renal function accompanied by histological changes.
Results
Eight renal transplant recipients were enrolled in the study from July 2018 to December 2019. Four patients experienced histologically confirmed transplant rejection. All four cases involved acute T-cell rejection. No significant correlation was found between the copeptin level and the presence or absence of rejection at any time point. In subgroup analyses, changes in creatinine, the estimated glomerular filtration rate, cystatin, and copeptin did not show statistical significance.
Conclusions
We anticipated that copeptin would be useful to identify individuals at high risk of transplant rejection; however, our study failed to show an association. Further research will be needed to overcome the limitations of this study.

Keyword

Copeptin; Graft rejection; Kidney transplantation

Figure

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  Fig. 1. Changes in median copeptin concentrations in patients with and without rejection.

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  Fig. 2. Changes in parameters over time for each patient. Changes in (A) the estimated glomerular filtration rate, (B) copeptin concentrations, (C) creatinine levels, and (D) cystatin C concentrations.

Reference

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