Low plasma homoarginine concentration is associated with high rates of all-cause mortality in renal transplant recipients.
Amino Acids
; 49(7): 1193-1202, 2017 07.
Article
en En
| MEDLINE
| ID: mdl-28429125
ABSTRACT
In renal transplant recipients (RTR), we recently found that low urinary excretion of homoarginine (hArg) is associated with mortality and graft failure. However, it is not known whether such prospective associations also hold true for plasma concentrations of hArg. In the present study, we therefore determined plasma concentrations of hArg in the same cohort, i.e. in 687 RTR (functioning graft ≥1 year), and in 140 healthy donors, before and after kidney donation. Plasma hArg concentrations were significantly lower in RTR compared to healthy controls [1.24 (0.95-1.63) µM vs. 1.58 (1.31-2.03) µM, P < 0.001], and kidney donation resulted in a decrease in plasma hArg concentration to 1.41 (1.10-1.81) µM (P < 0.001). In RTR, multivariable linear regression analysis revealed BMI (ß = 0.124), heart rate (ß = -0.091), pre-emptive transplantation (ß = 0.078), antidiabetic medication (ß = -0.091), eGFR (ß = 0.272), plasma PTH (ß = -0.098), uric acid (ß = 0.137), alkaline phosphatase (ß = -0.100), HDL (ß = -0.111), NT-pro-BNP (ß = -0.166), and urinary urea excretion (ß = 0.139) as main determinants of plasma hArg (all P < 0.05). In RTR, plasma hArg concentration was inversely associated with all-cause [hazard ratio (HR) 0.59 (95% CI 0.50-0.70), P < 0.001] and cardiovascular mortality [HR 0.50 (0.39-0.66), P < 0.001], both expressed per standard deviation change in log-transformed hArg, independent of potential confounders. To conclude, our results suggest that the kidney is a major hArg production site and an important modulator of hArg homeostasis in the renal and cardiovascular systems. Moreover, low plasma hArg is independently associated with increased risk of cardiovascular mortality in RTR, which corroborates the cardiovascular importance of preserving kidney function after transplantation.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_kidney_renal_pelvis_ureter_cancer
Asunto principal:
Trasplante de Riñón
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Rechazo de Injerto
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Homoarginina
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Amino Acids
Asunto de la revista:
BIOQUIMICA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Alemania