Osmoregulation Performance and Kidney Transplant Outcome.
Sodium
kidney transplantation
osmoregulation
Journal
Journal of the American Society of Nephrology : JASN
ISSN: 1533-3450
Titre abrégé: J Am Soc Nephrol
Pays: United States
ID NLM: 9013836
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
27
12
2018
accepted:
29
03
2019
pubmed:
21
6
2019
medline:
21
4
2020
entrez:
21
6
2019
Statut:
ppublish
Résumé
Kidney transplant recipients have an impaired ability to dilute urine but seldom develop baseline hyponatremia before ESRD. Although hyponatremia is a risk factor for adverse events in CKD and in kidney transplant recipients, it remains unclear whether subtler alterations in osmoregulation performance are associated with outcome. We studied a single-center prospective cohort of 1258 kidney transplant recipients who underwent a water-loading test 3 months after transplant to determine osmoregulation performance. Measured GFR (mGFR) was performed at the same visit. A group of 164 healthy candidates for kidney donation served as controls. We further evaluated the association of osmoregulation performance with transplantation outcomes and subsequent kidney function. Unlike controls, most kidney transplant recipients failed to maintain plasma sodium during water loading (plasma sodium slope of -0.6±0.4 mmol/L per hour in transplant recipients versus -0.12±0.3 mmol/L per hour in controls; Reduced osmoregulation performance occurs frequently in kidney transplant recipients and is an independent predictor of renal outcome.
Sections du résumé
BACKGROUND
Kidney transplant recipients have an impaired ability to dilute urine but seldom develop baseline hyponatremia before ESRD. Although hyponatremia is a risk factor for adverse events in CKD and in kidney transplant recipients, it remains unclear whether subtler alterations in osmoregulation performance are associated with outcome.
METHODS
We studied a single-center prospective cohort of 1258 kidney transplant recipients who underwent a water-loading test 3 months after transplant to determine osmoregulation performance. Measured GFR (mGFR) was performed at the same visit. A group of 164 healthy candidates for kidney donation served as controls. We further evaluated the association of osmoregulation performance with transplantation outcomes and subsequent kidney function.
RESULTS
Unlike controls, most kidney transplant recipients failed to maintain plasma sodium during water loading (plasma sodium slope of -0.6±0.4 mmol/L per hour in transplant recipients versus -0.12±0.3 mmol/L per hour in controls;
CONCLUSIONS
Reduced osmoregulation performance occurs frequently in kidney transplant recipients and is an independent predictor of renal outcome.
Identifiants
pubmed: 31217325
pii: ASN.2018121269
doi: 10.1681/ASN.2018121269
pmc: PMC6622417
doi:
Substances chimiques
Sodium
9NEZ333N27
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1282-1293Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 by the American Society of Nephrology.
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