The evaluation of the relationship between anti angiotensin type I antibodies in hypertensive patients undergoing kidney transplantation

Abstract Objectives We aimed to compare the anti-angiotensin II type I receptor (AT1R) antibody levels considering the development of anti-HLA antibodies after transplantation, pathologically confirmed humoral or vascular rejection reactions and late complications. Methods Forty-nine hypertensive patients who had presented to the Division of Nephrology, Transplantation Outpatient Clinic of Memorial Health Group Hospitals Transplant Units and Istanbul Medical Faculty for live kidney transplantation and underwent transplantation between 2015 and 2019, were included in our study. Among our patients (29 males/20 females), 76 % had primary hypertension, and 24 % had secondary hypertension. In this study, serum AT1R antibody levels before and after transplantation were measured using the Enzyme-Linked ImmunoSorbent Assay (ELISA) method. The anti-HLA antibody was detected with the Luminex method using the single antigen bead (SAB) assay. Results The AT1R antibody was found positive in 7 (18.9 %) of 37 patients who had primary hypertension and in 4 (33.3 %) of 12 patients who had secondary hypertension (p=0.426). The examination of the frequencies of development of post-transplant anti-HLA antibodies showed that the frequency of AT1R antibody positivity was found higher in the group with positive anti-HLA antibodies compared to the levels in the group with negative anti-HLA antibodies (p=0.002). The comparison of the pre-transplant and post-transplant values showed that the AT1R antibody level was statistically significantly decreased after transplantation [7.3/6.6 (3.2–21.1) vs. 6.2/4.7 (1.5–24.5), p=0.001]. Conclusions The findings of our study suggest that the evaluation of the AT1R antibody levels among non-HLA antibodies may be important for predicting the immunological risk before transplantation.