Metabolic acidosis and long-Term clinical outcomes in kidney transplant recipients
Journal of the American Society of Nephrology, ISSN: 1533-3450, Vol: 28, Issue: 6, Page: 1886-1897
2017
- 54Citations
- 47Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations54
- Citation Indexes53
- 53
- CrossRef41
- Policy Citations1
- Policy Citation1
- Captures47
- Readers47
- 47
Article Description
Metabolic acidosis (MA), indicated by low serum total CO2 (TCO2) concentration, is a risk factor for mortality and progressive renal dysfunction in CKD. However, the long-Term effects ofMA on kidney transplant recipients (KTRs) are unclear. We conducted a multicenter retrospective cohort study of 2318 adult KTRs, from January 1, 1997 to March 31, 2015, to evaluate the prevalence of MA and the relationships between TCO2 concentration and clinical outcomes. The prevalence of low TCO2 concentration (,22 mmol/L) began to increase in KTRs with EGFR,60 ml/min per 1.73 m2 and ranged from approximately 30% to 70% in KTRs with EGFR,30 ml/min per 1.73 m2. Multivariable Cox proportional hazards models revealed that low TCO2 concentration 3 months after transplant associated with increased risk of graft loss (hazard ratio [HR], 1.74%; 95% confidence interval [95% CI], 1.26 to 2.42) and death-censored graft failure (DCGF) (HR, 1.66; 95%CI, 1.14 to 2.42). Cox regressionmodels using time-varying TCO2 concentration additionally demonstrated significant associations between low TCO2 concentration and graft loss (HR, 3.48; 95% CI, 2.47 to 4.90),mortality (HR, 3.16; 95%CI, 1.77 to 5.62), and DCGF (HR, 3.17; 95%CI, 2.12 to 4.73).Marginal structuralCoxmodels adjusted for time-varyingEGFRfurther verified significant hazards of lowTCO2 concentration forgraft loss,mortality, andDCGF.Inconclusion,MAwasfrequent inKTRsdespite relativelypreserved renal function and may be a significant risk factor for graft failure and patient mortality, even after adjusting for EGFR.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85021692899&origin=inward; http://dx.doi.org/10.1681/asn.2016070793; http://www.ncbi.nlm.nih.gov/pubmed/28031407; http://www.jasn.org/lookup/doi/10.1681/ASN.2016070793; https://syndication.highwire.org/content/doi/10.1681/ASN.2016070793; https://journals.lww.com/00001751-201706000-00027; https://dx.doi.org/10.1681/asn.2016070793; https://journals.lww.com/jasn/fulltext/2017/06000/metabolic_acidosis_and_long_term_clinical_outcomes.27.aspx
American Society of Nephrology (ASN)
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