Development and validation of an optimized integrative model using urinary chemokines for noninvasive diagnosis of acute allograft rejection

Abstract

The urinary chemokines CXCL9 and CXCL10 are promising noninvasive diagnostic markers of acute rejection (AR) in kidney recipients, but their levels might be confounded by urinary tract infection (UTI) and BK virus (BKV) reactivation. Multiparametric model development and validation addressed these confounding factors in a training set of 391 samples, optimizing the diagnostic performance of urinary chemokines. CXCL9/creatinine increased in UTI and BKV viremia with or without nephropathy (BKVN) (no UTI/leukocyturia/UTI: −0.10/1.61/2.09, P =.0001 and no BKV/viremia/BKVN: −0.10/1.90/2.29, P