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High urine sIL-6R as a predictor of late graft failure in renal transplant recipients

Background. Chronic allograft nephropathy is an important cause of late renal transplant failure. Although numerous studies on cytokines have been carried out, the pathogenetic role of cytokines in chronic renal allograft nephropathy remains unclear. Methods. In a retrospective study, the authors compared posttransplant plasma and urine cytokine levels (interleukin [IL]-1&agr;, IL-1&bgr;, soluble [s] IL-1 receptor [R] antagonist [A], IL-2, sIL-2R, IL-3, IL-4, IL-6, sIL-6R, IL-10, tumor necrosis factor-&agr;, transforming growth factor-&bgr;2, and interferon-&ggr;) in 34 matched pairs of patients with or without late graft failure and in 50 matched pairs with either normal or increased serum creatinine levels and continued stable graft function. Results. Twelve and 6 months before late graft failure, urine levels of sIL-6R were significantly increased (P =0.003 and P =0.01, respectively). Serum creatinine levels were not associated with increased urine sIL-6R. Conclusion. High urine sIL-6R appears to be predictive of late graft failure in renal transplant recipients.