Biomarkers Plus Kidney Donor Profile Index Improve Prediction of Concordant Allograft Outcomes

MONDAY, Aug. 31, 2026 (HealthDay News) — Combining deceased kidney donor urinary biomarkers with the Kidney Donor Profile Index (KDPI) improves prediction of concordant allograft outcomes, according to a study published online July 9 in the Journal of the American Society of Nephrology.

Heather Thiessen Philbrook, from Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the potential of using KDPI and deceased donor urinary biomarkers to improve the assessment of organ quality and the prediction of allograft outcomes. Pairs of kidney recipients from the same donor were followed for three years posttransplant. Concordant good outcomes were defined as both recipients having an estimated glomerular filtration rate (eGFR) ≥45 mL/min per 1.73 m², while concordant poor outcomes were defined as both recipients experiencing graft failure or having an eGFR <20 mL/min per 1.73 m².

A total of 474 donors with both kidneys transplanted and with concordant good or poor outcomes (92 and 8 percent, respectively) were identified. The researchers found that the area under the receiver operating characteristic curve (AUC) was 0.80 for KDPI alone for distinguishing concordant good from concordant poor outcomes; the AUC was 0.86 for KDPI combined with uromodulin, osteopontin, and chitinase-3-like protein 1 measured by immunoassay. The AUC for KDPI plus three biomarkers was 0.85 compared with 0.81 for KDPI alone in a subset of 105 donors with lateral flow device measurements.

“These biomarkers tell us something the KDPI cannot: whether the kidney itself is repairing,” senior author Chirag R. Parikh, M.D., Ph.D., also from Johns Hopkins University School of Medicine, said in a statement. “That turns out to be a far better predictor of how it will work in a patient.”

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