After adjusting for potential confounding factors [age, gender, diabetes, eGFR, albuminuria, hypertension, and use of calcineurin inhibitors] only diabetes was significantly associated with urinary ACE2 activity (p = 0.003) and protein levels (p,0.001, Table 2 ) in transplant patients. An increase in urinary ACR was associated with urinary ACE2 protein by ELISA (p = 0.026), but not with ACE2 activity or ACE2 protein by western. Female gender was associated with higher urinary ACE2 mRNA levels in transplant patients (p = 0.004, Table 2 ).