scholarly journals Fish Intake, Circulating Mercury and Mortality in Renal Transplant Recipients

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1419 ◽  
Author(s):  
Camilo Sotomayor ◽  
António Gomes-Neto ◽  
Rijk Gans ◽  
Martin de Borst ◽  
Stefan Berger ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Fish Intake ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Omega 3 ◽  
Beneficial Effects ◽  
All Cause Mortality ◽  
Long Term Follow Up

Marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFAs) are inversely associated with cardiovascular and all-cause mortality in renal transplant recipients (RTRs). Recommendations to increase marine-derived n-3 PUFAs by increasing fish intake may have a drawback in concomitant stimulation of mercury intake, which could lead to higher circulating mercury concentrations and mitigation of otherwise beneficial effects of n-3 PUFAs. We aimed to monitor circulating mercury concentrations, and to prospectively evaluate whether it counteracts the potential association between fish intake and cardiovascular and all-cause mortality in a cohort of RTRs (n = 604, 53 ± 13 years-old, 57% men) with long-term follow-up (median of 5.4 years; 121 deaths). Circulating mercury concentration (median 0.30 (IQR 0.14–0.63) µg/L) positively associated with fish intake (std. β = 0.21, p < 0.001). Multivariable-adjusted Cox-proportional hazards regression analyses showed that prior to, and after additional adjustment for circulating mercury concentrations, fish intake was inversely associated with both cardiovascular (HR 0.75, 95% CI 0.58–0.96; and, HR 0.75, 95% CI 0.58–0.97, respectively) and all-cause mortality (HR 0.84, 95% CI 0.72–0.97; and, HR 0.86, 95% CI 0.74–0.99, respectively). Secondary analyses accounting for marine-derived n-3 PUFAs intake revealed associations of similar magnitude. In conclusion, we found no evidence of a counteracting effect conferred by circulating mercury concentrations on the associations between fish and marine-derived n-3 PUFAs intake and the risks of cardiovascular and all-cause mortality in RTRs.

scholarly journals Consumption of fruits and vegetables and cardiovascular mortality in renal transplant recipients: a prospective cohort study

2018 ◽  
Vol 35 (2) ◽  
pp. 357-365 ◽  
Author(s):  
Camilo G Sotomayor ◽  
António W Gomes-Neto ◽  
Michele F Eisenga ◽  
Ilja M Nolte ◽  
Josephine L C Anderson ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Cardiovascular Mortality ◽  
Fruits And Vegetables ◽  
Proportional Hazards ◽  
Vegetable Consumption ◽  
Cox Proportional Hazards ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Fruit Consumption

Abstract Background It currently remains understudied whether low consumption of fruits and vegetables after kidney transplantation may be a modifiable cardiovascular risk factor. We aimed to investigate the associations between consumption of fruits and vegetables and cardiovascular mortality in renal transplant recipients (RTRs). Methods Consumption of fruits and vegetables was assessed in an extensively phenotyping cohort of RTRs. Multivariable-adjusted Cox proportional hazards regression analyses were performed to assess the risk of cardiovascular mortality. Results We included 400 RTRs (age 52 ± 12 years, 54% males). At a median follow-up of 7.2 years, 23% of RTRs died (53% were due to cardiovascular causes). Overall, fruit consumption was not associated with cardiovascular mortality {hazard ratio [HR] 0.82 [95% confidence interval (CI) 0.60–1.14]; P = 0.24}, whereas vegetable consumption was inversely associated with cardiovascular mortality [HR 0.49 (95% CI 0.34–0.71); P &lt; 0.001]. This association remained independent of adjustment for several potential confounders. The association of fruit consumption with cardiovascular mortality was significantly modified by estimated glomerular filtration rate (eGFR; Pinteraction = 0.01) and proteinuria (Pinteraction = 0.01), with significant inverse associations in patients with eGFR &gt; 45 mL/min/1.73 m2 [HR 0.56 (95% CI 0.35–0.92); P = 0.02] or the absence of proteinuria [HR 0.62 (95% CI 0.41–0.92); P = 0.02]. Conclusions In RTRs, a relatively higher vegetable consumption is independently and strongly associated with lower cardiovascular mortality. A relatively higher fruit consumption is also associated with lower cardiovascular mortality, although particularly in RTRs with eGFR &gt; 45 mL/min/1.73 m2 or an absence of proteinuria. Further studies seem warranted to investigate whether increasing consumption of fruits and vegetables may open opportunities for potential interventional pathways to decrease the burden of cardiovascular mortality in RTRs.

scholarly journals Whole-body arginine dimethylation is associated with all-cause mortality in adult renal transplant recipients

Amino Acids ◽  
2021 ◽  
Author(s):  
Adrian Post ◽  
Alexander Bollenbach ◽  
Stephan J. L. Bakker ◽  
Dimitrios Tsikas
Keyword(s):  
Renal Transplant ◽  
Excretion Rate ◽  
Whole Body ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Donors ◽  
Body Protein ◽  
All Cause Mortality ◽  
Arginine Residues ◽  
Excretion Rates

AbstractArginine residues in proteins can be singly or doubly methylated post-translationally. Proteolysis of arginine-methylated proteins provides monomethyl arginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). ADMA and SDMA are considered cardiovascular risk factors, with the underlying mechanisms being not yet fully understood. SDMA lacks appreciable metabolism and is almost completely eliminated by the kidney, whereas ADMA is extensively metabolized to dimethylamine (DMA), with a minor ADMA fraction of about 10% being excreted unchanged in the urine. Urinary DMA and ADMA are useful measures of whole-body asymmetric arginine-dimethylation, while urinary SDMA serves as a whole-body measure of symmetric arginine-dimethylation. In renal transplant recipients (RTR), we previously found that higher plasma ADMA concentrations and lower urinary ADMA and SDMA concentrations were associated with a higher risk of all-cause mortality. Yet, in this RTR collective, no data were available for urinary DMA. For the present study, we additionally measured the excretion rate of DMA in 24-h collected urine samples of the RTR and of healthy kidney donors in the cohort, with the aim to quantitate whole-body asymmetric (ADMA, DMA) and symmetric (SDMA) arginine-dimethylation. We found that lower DMA excretion rates were associated with higher all-cause mortality, yet not with cardiovascular mortality. In the healthy donors, kidney donation was associated with considerable decreases in ADMA (by − 39%, P < 0.0001) and SDMA (by − 21%, P < 0.0001) excretion rates, yet there was no significant change in DMA (by − 9%, P = 0.226) excretion rate. Our results suggest that protein-arginine dimethylation is altered in RTR compared to healthy kidney donors and that it is pronouncedly shifted from symmetric to asymmetric arginine-dimethylation, with whole-body protein-arginine dimethylation being almost unaffected.

scholarly journals Plasma ADMA associates with all-cause mortality in renal transplant recipients

Amino Acids ◽  
2015 ◽  
Vol 47 (9) ◽  
pp. 1941-1949 ◽  
Author(s):  
Anne-Roos S. Frenay ◽  
Else van den Berg ◽  
Martin H. de Borst ◽  
Bibiana Beckmann ◽  
Dimitrios Tsikas ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Plasma Adma ◽  
All Cause Mortality

Dietary Omega-3 Fatty Acid Intake and Mortality in CKD Population: A 1999–2014 NHANES Analysis

2021 ◽  
pp. 1-10
Author(s):  
Wei-Lan Li ◽  
Nan-Hui Zhang ◽  
Shu-Wang Ge ◽  
Gang Xu
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acid ◽  
Proportional Hazards ◽  
Early Death ◽  
Cox Proportional Hazards ◽  
Omega 3 ◽  
Pufa Intake ◽  
Dietary Recall ◽  
Cox Proportional Hazards Models ◽  
All Cause Mortality

<b><i>Introduction:</i></b> High risk of early death, especially contributed to cardiovascular disease, exists in patients who have chronic kidney disease (CKD). And the burden of cardiovascular disease is able to be lightened by an increase in omega-3 polyunsaturated fatty acid (omega-3 PUFA). A diet high in omega-3 PUFA in the general population is protective, although it is inconclusive about its beneficial role in the CKD population. <b><i>Methods:</i></b> From the 1999 to 2014 National Health and Nutrition Examination Surveys (NHANES), we can collect 2,990 participants who suffered from CKD, who were classified into 4 groups: &#x3c;0.86, 0.87–1.30, 1.31–1.92, and 1.93–9.65 g/day based on NHANES 24-h dietary recall questionnaire dietary omega-3 PUFA. Moreover, their mortality details were available to be obtained by linking NHANES to the National Death Index. The associations between dietary omega-3 PUFA and mortality were evaluated by constructing multivariable Cox proportional hazards models. <b><i>Results:</i></b> Over 8 years of a median follow-up, 864 deaths were recorded. The adjusted hazard ratios (95% confidence interval) for all-cause mortality of the diseased people with CKD in the 2nd (0.87–1.30 g/day), 3rd (0.87–1.30 g/day), and 4th (1.93–9.65 g/day) quartiles of dietary omega-3 PUFA were 0.94 (0.72, 1.23), 0.74 (0.54, 1.02), and 0.67 (0.48, 0.93), respectively, versus those with the lowest quartile of dietary omega-3 PUFA intake (&#x3c;0.86 g/day) (<i>p</i> for trend = 0.011). <b><i>Conclusion:</i></b> There may be a inverse relation of dietary omega-3 PUFA intake and all-cause mortality in patients with CKD. Therefore, an increase of dietary omega-3 PUFA may be encouraged to be used clinically in patients with CKD.

scholarly journals Plasma Malondialdehyde and Risk of New-Onset Diabetes after Transplantation in Renal Transplant Recipients: A Prospective Cohort Study

2019 ◽  
Vol 8 (4) ◽  
pp. 453 ◽  
Author(s):  
Manuela Yepes-Calderón ◽  
Camilo Sotomayor ◽  
António Gomes-Neto ◽  
Rijk Gans ◽  
Stefan Berger ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Transplant ◽  
Cox Proportional Hazards ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Dietary Antioxidants ◽  
Onset Diabetes ◽  
Plasma Malondialdehyde ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is a frequent complication in renal transplant recipients (RTR). Although oxidative stress has been associated with diabetes mellitus, data regarding NODAT are limited. We aimed to prospectively investigate the long-term association between the oxidative stress biomarker malondialdehyde (measured by high-performance liquid chromatography) and NODAT in an extensively phenotyped cohort of non-diabetic RTR with a functioning graft ≥1 year. We included 516 RTR (51 ± 13 years-old, 57% male). Median plasma malondialdehyde (MDA) was 2.55 (IQR, 1.92–3.66) µmol/L. During a median follow-up of 5.3 (IQR, 4.6–6.0) years, 56 (11%) RTR developed NODAT. In Cox proportional-hazards regression analyses, MDA was inversely associated with NODAT, independent of immunosuppressive therapy, transplant-specific covariates, lifestyle, inflammation, and metabolism parameters (HR, 0.55; 95% CI, 0.36–0.83 per 1-SD increase; p < 0.01). Dietary antioxidants intake (e.g., vitamin E, α-lipoic acid, and linoleic acid) were effect-modifiers of the association between MDA and NODAT, with particularly strong inverse associations within the subgroup of RTR with relatively higher dietary antioxidants intake. In conclusion, plasma MDA concentration is inversely and independently associated with long-term risk of NODAT in RTR. Our findings support a potential underrecognized role of oxidative stress in post-transplantation glucose homeostasis.

Epidemiology, Risk Factors, and Outcomes After Early Posttransplant Clostridiodes difficile Infection in Renal Transplant Recipients

2019 ◽  
Vol 53 (10) ◽  
pp. 1020-1025
Author(s):  
Margaret R. Jorgenson ◽  
Jillian L. Descourouez ◽  
Dou-Yan Yang ◽  
Glen E. Leverson ◽  
Christopher M. Saddler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplant ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Female Gender ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Secondary Outcome ◽  
Induction Agent ◽  
Renal Transplant Recipients

Background: Modifiable risk-factors associated with Clostridioides difficile infection (CDI) in renal-transplant (RTX) have not been clearly established and peri-transplant risk has not been described. Objective: Evaluate epidemiology, risk-factors and outcomes after CDI occurring in the first 90 days after RTX (CDI-90).Methods: Observational cohort study/survival analysis of adult RTX recipients from 1/1/2012-12/31/2015. Primary outcome was CDI-90 incidence/risk-factors. Secondary outcome was evaluation of post-90 day transplant outcomes. Results: 982 patients met inclusion criteria; 46 with CDI-90 and 936 without (comparator). CDI incidence in the total population was 4.7% at 90 days, 6.3% at 1 year, and 6.4% at 3 years. Incidence of CDI-90 was 5%; time to diagnosis was 19.4±25 days (median 7). Risk-factors for CDI-90 were alemtuzumab induction (Hazard ratio [HR] 1.5, 95% CI(1.1-2.0), p = 0.005) and age at transplant (HR 1.007/year, 95% CI (1.002-1.012), p= 0.007). However, risk-factors for CDI at any time were different; donation-after-circulatory-death (DCD) donor (HR 2.5 95% CI (1.3-4.9), p = 0.008) and female gender (HR 1.6 95% CI (1.0-2.7), p = 0.049). On Kaplan-Meier, CDI-90 appeared to have an impact on patient/graft survival, however when analyzed in a multivariable stepwise Cox proportional hazards model, only age was significantly associated with survival ( p = 0.002). Conclusion and Relevance: Incidence of CDI-90 is low, mostly occurring in the first post-operative month. Risk-factors vary temporally based on time from transplant. In the early post-op period induction agent and age at transplant are significant, but not after. Associations between CDI and negative graft outcomes appear to be largely driven by age. Future studies validating these risk-factors as well as targeted prophylaxis strategies and their effect on long term graft outcomes and the host microbiome are needed.

Low plasma homoarginine concentration is associated with high rates of all-cause mortality in renal transplant recipients

Amino Acids ◽  
2017 ◽  
Vol 49 (7) ◽  
pp. 1193-1202 ◽  
Author(s):  
Arslan Arinc Kayacelebi ◽  
Isidor Minović ◽  
Erik Hanff ◽  
Anne-Roos S. Frenay ◽  
Martin H. de Borst ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
All Cause Mortality

Long-term follow-up of ABO-incompatible renal transplant recipients

1999 ◽  
Vol 31 (1-2) ◽  
pp. 256-257 ◽  
Author(s):  
H Karakayali ◽  
G Moray ◽  
A Demirağ ◽  
M Turan ◽  
N Bilgin ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Long Term Follow Up
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