A new study, sponsored by the National Institutes of Health, finds there may be an easier way to determine whether a body will reject a new kidney: Through urine. Erin Billups filed the following report.
Barbara Natoli's kidneys were damaged during a massive hemorrhaging in 2004.
"I was under treatment trying to control my blood pressure," Natoli said. "My kidneys were deteriorating."
So in 2006, Natoli received a kidney transplant from her daughter. She was a perfect candidate for an ongoing study at New York Presbyterian-Weill Cornell Medical Center, exploring whether genes in the urine can predict rejection of the transplanted kidney.
"A rise in this three gene signature reflects inflammation within the kidne, and inflammation is what we see when we diagnose kidney rejection," said Dr. Darshana Dadhania, a transplant nephrologist at New York-Presbyterian Hospital/Weill Cornell Medical Center
The latest study, published in the New England Journal of Medicine, involved 4,300 urine samples from 485 kidney transplant patients from five different institutions. It's the third and largest study in a series, showing that it is possible to forego an invasive kidney biopsy.
"Now, using this test to diagnose rejection, all the patient has to do is give a urine sample," Dadhania said.
It could mean less time and money spent in the hospital.
Natoli's kidney showed signs of possible rejection. She could have benefited from the test.
"You're talking a urine sample against a biopsy," Natoli said. "I'll give a urine sample any day."
Transplant patients involved in the clinical trial, like Natoli, were not treated based on the test results discovered, but that would be the next step.
"We need it to be approved as a clinical test before we can use it clinically," Dadhania said.
Right now, transplant patients are given immune suppressing drugs to prevent rejection of the kidney, without knowing whether it's needed or not. Dadhania and her colleagues hope the new test will eventually be used to tailor treatments more effectively for patients.
"This is a test that can be used at every office visit," Dadhania said. "If there is inflammation, as diagnosed by this non-invasive urine test, then we can adjust the drugs to suppress that inflammation and hopefully prevent future damage."