Plasma Vitamin C and Risk of Late Graft Failure in Kidney Transplant Recipients: Results of the TransplantLines Biobank and Cohort Study
| Autor: | Robin P. F. Dullaart, Stephan J. L. Bakker, Stefan P Berger, Nicolas I. Bustos, Camilo G. Sotomayor, Gerjan Navis, Manuela Yepes-Calderón, Ramón Rodrigo, Diego Arauna, Martin H. de Borst |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Value, Affordability and Sustainability (VALUE) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Vitamin
medicine.medical_specialty HEMODIALYSIS BLOOD Physiology CYCLOSPORINE-A medicine.medical_treatment graft failure Clinical Biochemistry 030232 urology & nephrology Renal function kidney transplantation vitamin C RM1-950 030204 cardiovascular system & hematology high-density lipoprotein Biochemistry Gastroenterology Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine INFLAMMATION QUALITY-OF-LIFE Internal medicine medicine oxidative stress Renal replacement therapy Molecular Biology ATTENUATES OXIDATIVE STRESS triglycerides Dialysis Kidney transplantation ALL-CAUSE MORTALITY NITRIC-OXIDE Vitamin C Proportional hazards model business.industry RENAL REPLACEMENT THERAPY Cell Biology medicine.disease surgical procedures operative chemistry CARDIOVASCULAR-DISEASE Hemodialysis Therapeutics. Pharmacology business |
| Zdroj: | Antioxidants Antioxidants (Basel, Switzerland), 10(5):631. MDPI AG Antioxidants, Vol 10, Iss 631, p 631 (2021) Volume 10 Issue 5 |
| ISSN: | 2076-3921 |
| Popis: | Recent studies have shown that depletion of vitamin C is frequent in outpatient kidney transplant recipients (KTR) and that vitamin C is inversely associated with risk of death. Whether plasma vitamin C is associated with death-censored kidney graft failure remains unknown. We investigated KTR who participated in the TransplantLines Insulin Resistance and Inflammation Biobank and Cohort Study. The primary outcome was graft failure (restart of dialysis or re-transplantation). Overall and stratified (pinteraction < 0.1) multivariable-adjusted Cox regression analyses are presented here. Among 598 KTR (age 51 ± 12 years-old 55% males), baseline median (IQR) plasma vitamin C was 44.0 (31.0–55.3) µmol/L. Through a median follow-up of 9.5 (IQR, 6.3‒10.2) years, 75 KTR developed graft failure (34, 26, and 15 events over increasing tertiles of vitamin C, log-rank p < 0.001). Plasma vitamin C was inversely associated with risk of graft failure (HR per 1–SD increment, 0.69 95% CI 0.54–0.89 p = 0.004), particularly among KTR with triglycerides ≥1.9 mmol/L (HR 0.46 95% CI 0.30–0.70 p < 0.001 pinteraction = 0.01) and among KTR with HDL cholesterol ≥0.91 mmol/L (HR 0.56 95% CI 0.38–0.84 p = 0.01 pinteraction = 0.04). These findings remained materially unchanged in multivariable-adjusted analyses (donor, recipient, and transplant characteristics, including estimated glomerular filtration rate and proteinuria), were consistent in categorical analyses according to tertiles of plasma vitamin C, and robust after exclusion of outliers. Plasma vitamin C in outpatient KTR is inversely associated with risk of late graft failure. Whether plasma vitamin C‒targeted therapeutic strategies represent novel opportunities to ease important burden of graft failure necessitates further studies. |
| Databáze: | OpenAIRE |
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