A Study of the Correlation Between Donor UDP-Glc and Transplanted Kidney Function

NCT ID: NCT06707272

Last Updated: 2024-12-03

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 200 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-06-01
• Study Completion Date: 2024-10-10

Brief Summary

Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD), however, organ shortage is the primary bottleneck restricting the progression of organ transplantation.1 Organs from Expanded Criteria Donors (ECD) have the potential to greatly increase the donor organ pool. However, they also require careful selection and utilization. Deceased kidney donors often had a history of central nervous system fluid regulation disorders and inflammation mediator release, which led to hemodynamic instability, electrolyte and acid-base imbalances, and with a higher risk of primary graft non-function (PNF) or delayed graft function (DGF) post-transplantation.2,3 Searching for appropriate and effective biomarkers to assess renal quality and predict DGF is a hot topic in the field of kidney transplantation.

Uridine diphosphate-glucose (UDP-Glc) is a damage-associated molecular pattern molecule (DAMPs) released by damaged cells.4 UDP-Glc is synthesized in the cytoplasm, then transported into the lumen of the endoplasmic reticulum and Golgi apparatus, where it regulates the synthesis of carbohydrates and acts as a substrate to facilitate glycosylation reactions.5 And UDP-Glc is an endogenous excitant of the G protein-coupled P2Y14 receptor.6 Additionally, the human P2Y14 receptor is expressed at high levels in adipose tissue, stomach, intestines, specific regions of the brain, skeletal muscle, spleen, lungs, and heart.7 UDP-Glc released plays a significant role in extracellular signaling within these tissues.8 Activation of P2Y14 promotes neutrophil infiltration, the recruitment of monocytes and macrophages, and the activation of the immune response, ultimately leading to tissue damage.9 Research has discovered that intercalated cells (ICs) in the collecting duct of the kidney act as sensors for UDP-Glc, and when the P2Y14 receptor on their apical membrane is activated, ICs produce chemotactic cytokines that attract neutrophils to the kidney, causing kidney inflammation and the onset of acute kidney injury (AKI).10,11 Furthermore, studies have shown that the concentration of UDP-Glc in the urine of AKI patients is higher compared to patients without AKI.12 UDP-Glc hydrolyzes slowly in the extracellular environment, which results in UDP-Glc being highly stable and easily detectable.5,13 In conclusion, donor urinary UDP-Glc can be serve as an appropriate and effective biomarkers to assess renal quality and predict DGF.

The study aimed to investigated the correlation between donor urinary UDP-Glc levels and graft function post-transplant in recipients. We hypothesized that the higher the donor urinary UDP-Glc levels, the more severe the kidney damage, resulting in a higher probability of DGF. It will provide transplant surgeons with a novel strategy to predict DGF earlier and more accurately without invasive procedures, while also reducing medical costs.

Conditions

Renal Transplant

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

delayed graft function

Delay graft function (DGF) was defined as the need for dialysis treatment within the first week following transplantation or Scr at post-transplant 1 week (POW1) ≥ 4.52 mg/dL.

No interventions assigned to this group

Immediate graft function

Immediate graft function (IGF) was defined as Scr at POW1 \< 2.50 mg/dL, and slow graft function (SGF) was defined as Scr at POW1 ≥ 2.50 mg/dL.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• donors who met the criteria for kidney donation
• recipients who met the criteria for kidney transplantation
• informed consent form signed
• organs from deceased donors
• completed the family consent form for human organ donation.

Exclusion Criteria

• donors without urine samples
• recipients with multiple organ transplantation
• participation in other clinical trials
• recipients died in perioperation period
• recipients experienced kidney transplant nephrectomy in perioperation period
• recipients did not have a follow-up visit at our center with 1 month after being first discharged
• other features considered unsuitable by researchers.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Qianghua Leng

OTHER

Sponsor Role: lead

Responsible Party

Qianghua Leng

Principal Investigator

Responsibility Role: SPONSOR_INVESTIGATOR

Locations

The Third Affiliated Hospital of Sun Yat-sen University

Guangzhou, Guangdong, China

Countries

China

References

Ma M, Han F, Leng Q, Chen X, Tang Z, Zhang J, Luo Y, Zhang Y, Huang Z, Na N. Preoperative donor urinary UDP-Glc as an independent risk factor for delayed graft function. Front Immunol. 2025 Mar 17;16:1545280. doi: 10.3389/fimmu.2025.1545280. eCollection 2025.

Reference Type: DERIVED

PMID: 40165952 (View on PubMed)

Other Identifiers

II2024-047-02

Identifier Type: -

Identifier Source: org_study_id