Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study
Journal
Journal of Clinical Medicine
ISSN
2077-0383
Date Issued
2020
Author(s)
Camilo G. Sotomayor
Dion Groothof
Joppe J. Vodegel
Tomás A. Gacitúa
António W. Gomes-Neto
Maryse C. J. Osté
Robert A. Pol
Catterina Ferreccio
Stefan P. Berger
Guillermo Chong
Riemer H. J. A. Slart
Ramón Rodrigo
Gerjan J. Navis
Daan J. Touw
Stephan J. L. Bakker
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:p>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 (2008‒2011), 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, 1.04‒2.04) µg/L. In backwards linear regression analyses we found that fish consumption (std β = 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.</jats:p>
Subjects
arsenic
;
diet
;
fish consumption
;
oxidative stress
;
kidney transplantation
;
graft failure
;
arsenic
;
aspartate aminotransferase
;
c reactive protein
;
cadmium
;
calcium
;
cholesterol
;
creatinine
;
cystatin c
;
gamma glutamyltransferase
;
glucose
;
high density lipoprotein cholesterol
;
low density lipoprotein cholesterol
;
phosphate
;
triacylglycerol
;
adult
;
age
;
alcohol consumption
;
arsenic blood level
;
article
;
biobank
;
blood level
;
bread
;
calcium blood level
;
chronic kidney failure
;
clinical outcome
;
cohort analysis
;
controlled study
;
creatinine blood level
;
diabetes mellitus
;
dietary intake
;
end stage renal disease
;
enzyme linked immunosorbent assay
;
estimated glomerular filtration rate
;
female
;
fish consumption
;
follow up
;
food frequency questionnaire
;
graft failure
;
graft recipient
;
graft survival
;
heavy metal blood level
;
hemodialysis
;
human
;
immunosuppressive treatment
;
inductively coupled plasma mass spectrometry
;
kidney disease
;
kidney function
;
kidney graft
;
kidney transplantation
;
major clinical study
;
male
;
phosphate blood level
;
potato
;
prospective study
;
proteinuria
;
rice
;
risk factor
;
sex difference
;
systolic blood pressure
;
tea