More than 40,000 Canadians have end-stage kidney disease (ESKD). Approximately 60 per cent of these undergo dialysis. The cost of dialysis can reach $200,000 per patient per year in remote areas of Manitoba and amounts to over $2 billion per year in Canada.

Nevertheless, approximately 50 per cent of these patients typically die within four years. Kidney transplantation improves ESKD patient survival and quality of life and reduces costs. Unfortunately, one in three patients will experience transplant rejection within a year, leading to a considerably reduced survival rate.

Although early detection and early treatment can dramatically reduce the risk of rejection and death, current clinical testing fails to detect rejection early enough. Therefore, we are investigating whether a specific molecule in urine, the protein CXCL10, enables early detection of rejection and can predict outcomes.

CXCL10 urine levels are clearly higher in patients with transplant rejection, allowing not only early detection but also personalized treatment. However, predictions made based on the currently available testing method are often not accurate. A probable reason is that these tests cannot distinguish between different forms of the CXLC10 protein. Although these different forms are almost identical, they have very different effects – some of them may accelerate rejection, while others may slow it down.

We will develop a more specific test to clearly distinguish these different forms of urinary CXCL10 and thus improve its diagnostic value for transplant patients. Ultimately, this will enable more personalized patient treatment to yield better outcomes, higher survival rates and a better quality of life, while reducing costs.