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Is Metabolic Acidosis a Novel Risk Factor for a Long-Term Graft Survival in Patients after Kidney Transplantation?
Gojowy, Damian; Skiba, Katarzyna; Bartmanska, Magdalena; Kolonko, Aureliusz; Wiecek, Andrzej; Adamczak, Marcin.
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  • Gojowy D; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
  • Skiba K; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
  • Bartmanska M; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
  • Kolonko A; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
  • Wiecek A; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
  • Adamczak M; Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland, madamczak1@op.pl.
Kidney Blood Press Res ; 45(5): 702-712, 2020.
Article en En | MEDLINE | ID: mdl-32799205
BACKGROUND: Results of both experimental and clinical studies suggest that metabolic acidosis (MA) contributes to the progression of chronic kidney disease (CKD) and mortality in CKD patients. It is unknown whether the same relationship exists in kidney transplantation (KTx) patients. The aim of this observational study was to examine this relationship between MA and both mortality and renal outcomes in patients after KTx. METHODS: Four hundred eighty-six (290 male; 196 female) patients aged 48 ± 12 years, at least 1 year after KTx, were analyzed. Blood HCO3- was measured, and patients were then observed over 3 years. MA was defined as the blood HCO3- concentration <22 mmol/L. The end points of survival analysis were death and initiation of dialysis therapy. In patients who did not reach the above-mentioned end points, the difference between final (after 3 years of follow-up) and initial estimated glomerular filtration rate (eGFR) was calculated. RESULTS: MA was initially diagnosed in 57 (12%) patients after KTx. Three-year patient survival was 89.5% in the MA group and 97.4% in the non-MA group (p = 0.001). Three-year graft survival was 73.7% for patients with MA and 93.0% for patients without MA (p < 0.001). In patients with MA who did not reach study end points, blood bicarbonate concentration at baseline correlated positively with a change in eGFR (R = 0.48, p = 0.002, n = 36). Such a correlation was not found in patients without MA (n = 388). CONCLUSIONS: (1) MA significantly increases the risk of mortality in patients after KTx. (2) The intensity of MA may be associated with progression of transplanted kidney dysfunction in KTx patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acidosis / Trasplante de Riñón / Insuficiencia Renal Crónica / Supervivencia de Injerto Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Kidney Blood Press Res Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acidosis / Trasplante de Riñón / Insuficiencia Renal Crónica / Supervivencia de Injerto Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Kidney Blood Press Res Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza