Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study

被引：11

作者：

Sotomayor, Camilo G. ^{[1
]}

Groothof, Dion ^{[1
]}

Vodegel, Joppe J. ^{[1
]}

Gacitua, Tomas A. ^{[1
]}

Gomes-Neto, Antonio W. ^{[1
]}

Oste, Maryse C. J. ^{[1
]}

Pol, Robert A. ^{[2
]}

Ferreccio, Catterina ^{[3
]}

Berger, Stefan P. ^{[1
]}

Chong, Guillermo ^{[4
]}

Slart, Riemer H. J. A. ^{[5
]}

Rodrigo, Ramon ^{[6
]}

Navis, Gerjan J. ^{[1
]}

Touw, Daan J. ^{[7
]}

Bakker, Stephan J. L. ^{[1
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Internal Med, NL-9700 RB Groningen, Netherlands

[2] Univ Groningen, Univ Med Ctr Groningen, Div Transplantat Surg, NL-9700 RB Groningen, Netherlands

[3] Pontificia Univ Catolica Chile, Adv Ctr Chron Dis, Santiago 8330033, Chile

[4] Univ Desarrollo, Clin Alemana Santiago, Dept Radiol, Santiago 7610658, Chile

[5] Univ Groningen, Univ Med Ctr Groningen, Dept Nucl & Mol Imaging, NL-9700 RB Groningen, Netherlands

[6] Univ Chile, Inst Biomed Sci, Fac Med, Santiago 8380453, Chile

[7] Univ Groningen, Univ Med Ctr Groningen, Dept Pharm & Clin Pharmacol, NL-9700 RB Groningen, Netherlands

来源：

JOURNAL OF CLINICAL MEDICINE | 2020年 / 9卷 / 02期

关键词：

arsenic; diet; fish consumption; oxidative stress; kidney transplantation; graft failure; DRINKING-WATER; EXPOSURE; TOXICITY; METABOLISM; MORTALITY; VEGETABLES; SPECIATION; VALIDITY; MERCURY; CANCER;

D O I：

10.3390/jcm9020417

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Arsenic is toxic to many organ systems, the kidney being the most sensitive target organ. We aimed to investigate whether, in kidney transplant recipients (KTRs), the nephrotoxic exposure to arsenic could represent an overlooked hazard for graft survival. We performed a prospective cohort study of 665 KTRs with a functional graft >= 1 year, recruited in a university setting (20082011), in The Netherlands. Plasma arsenic was measured by ICP-MS, and dietary intake was comprehensively assessed using a validated 177-item food-frequency questionnaire. The endpoint graft failure was defined as restart of dialysis or re-transplantation. Median arsenic concentration was 1.26 (IQR, 1.042.04) mu g/L. In backwards linear regression analyses we found that fish consumption (std beta = 0.26; p < 0.001) was the major independent determinant of plasma arsenic. During 5 years of follow-up, 72 KTRs developed graft failure. In Cox proportional-hazards regression analyses, we found that arsenic was associated with increased risk of graft failure (HR 1.80; 95% CI 1.28-2.53; p = 0.001). This association remained materially unaltered after adjustment for donor and recipient characteristics, immunosuppressive therapy, eGFR, primary renal disease, and proteinuria. In conclusion, in KTRs, plasma arsenic is independently associated with increased risk of late graft failure.

引用

页数：14

共 63 条

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