The Use of Urinary Dickkopf 3 (u DKK3) as a New Biomarker Which Can Identify Patients at High Risk of Renal Allograft Dysfunction, Earlier That the Current Established Tests.

Kidney function after a renal transplant is monitored closely, particularly in the first year, as the risk of deterioration in graft function is worrying. Graft dysfunction can lead to chronic kidney failure and graft loss. Currently, renal transplant function is mainly monitored using creatinine and estimated glomerular filtration rate (eGFR). However, these tests are not sensitive enough to detect small changes in graft function. A new test which can detect graft dysfunction in an early phase would be useful as this would help optimise treatment and prolong survival. Dickkopf -3 (DKK3) is a protein which is released by kidney cells in response to injury. High levels of the DKK3 protein in urine has been shown to have the potential to predict decline in graft function, earlier than the currently available tests, although the results show a mixed picture. Before this test is used routinely, further studies need to be carried out. We want to analyse this protein in multiple urine samples collected over 12 months in our cohort of renal transplant recipients. We will be comparing the urine DKK3 test with our currently available tests to investigate whether this test can identify patients who are at risk of graft dysfunction earlier.