Evaluation of serum tumor necrosis factor alpha and its correlation with histology in chronic kidney disease, stable renal transplant and rejection cases.

Tumor necrosis factor alpha (TNF alpha) is a cytokine secreted by macrophages, helper T cells, natural killer cells, B lymphocytes and non lymphoid cells e.g. endothelial cells, fibroblast and tumor cell lines. Aim of the study was to find the utility of TNF alpha in diagnosing renal transplant rejection among the renal transplant cases (n=29), and comparison with the levels in patients on maintenance hemodialysis (n=21) and healthy controls (n=20). TNF alpha in healthy controls varied from 2 to 15 pg/mL. In chronic renal failure and renal transplant rejection cases TNF alpha was above 45 pg/mL. In stable renal transplant patients it was higher than normal (16 to 30 pg/mL). In both acute and chronic transplant rejection TNF alpha increase correlated well with histology. Thus our study suggests that TNF alpha level more than 45 pg/mL can be taken as an immunological marker of renal transplant rejection.