FP729INFLAMMATORY PHENOTYPES AND TAILORED RISK EVALUATION IN KIDNEY TRANSPLANTATION

Abstract

Introduction and Aims: Terminal kidney failure is associated with persistent systemic inflammation, but the clinical importance of this is speculative and poorly explored. Chronic inflammation also predisposes to insulin resistance, dyslipidemia, endothelial dysfunction, accelerated atherosclerosis, neurodegeneration, anemia and sarcopenia and thereby to a network of chronic diseases such as type 2 diabetes mellitus, cardiovascular disease, dementia and the syndrome of frailty. The aim of this project is to investigate the effects and clinical importance of systemic inflammation in renal failure patients before and after kidney transplantation. Method(s): A retrospective cohort of kidney transplanted patients at the Department of Nephrology, Capital region of Denmarkfrom 2009 to 2015 (n=619). Endpoints were defined as graft loss, thromboembolic events and death. Inflammatory cytokines, cytokine-specific autoantibodies, hsCRP and endothelial markers were measured at the time of transplantation. Result(s): IL-10 were found to be independently associated with death (9%, n=56) in a cox-regression analysis adjusted for recipient factors (age, sex, previous cardiovascular or diabetic disease) and donor factors (donation type, age and sex) with HR=1.48 (95%CI 1.21-1.80), P=0.000. Similar results were found for hsCRP and TNFa measured at the time of transplantation. Anti-IL-10 cytokine-specific autoantibodies were found to be independently associated with thromboembolic events (9%, n=57) adjusted for age, sex, previous thromboembolic events and previous diabetes, with a HR: 1.57 (95%CI 1.24-1.99), P=0.000. Conclusion(s): Our results reveal that inflammatory markers at the time of transplantation are independent predictors of both death and thromboembolic events after transplantation.