Objective To assess the clinical value of early detection of the risk of graft dysfunction in post-renal trans-plant patients after continued use of tacrolimus(Tac)by combined detection of urinary microalbumin(MA),blood urea nitrogen(BUN),serum creatinine(sCr)and estimated glomerular filtration rate(eGFR).Methods Fifty-four renal transplant patients who had been using Tac for a long time and were admitted to Ningbo Hospital for urinary nephropathy between August 2015 and July 2020 were selected.The patients were divided into two groups:group A,which used Tac continuously for 12 months,and group B,which used Tac continuously for 24 months.The clinical value of MA,BUN,sCr,eGFR and combined detection were evaluated through comparative analysis.Results Compared to group A,group B showed significant differences in MA and eGFR(P＜0.05),but not in BUN and sCr(P＞0.05).There was a negative correlation between eGFR and MA,BUN and sCr[r values of 12 months(group A)and 24 months(group B)were-0.413,-0.538,-0.797(P＜0.01)and-0.333,-0.647,-0.738(P＜0.05),respectively],and was significantly correlated with Tac duration,particularly in the early post-transplantation period.Based on the receiver operating charac-teristic curve,the AUC for MA,BUN,sCr and eGFR individually were 0.680,0.594,0.581 and 0.689,respectively.The combined detection of the four indicators resulted in an AUC of 0.839.Conclusion The detection of four renal inju-ry markers(MA,BUN,sCr and eGFR)can aid in the early diagnosis of renal insufficiency in patients who continue to use Tac after renal transplantation.
Kidney transplantRenal function impairmentTacrolimusMarkerCombined detection
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