TY - JOUR
T1 - Delayed Graft Function After Kidney Transplantation
T2 - The Role of Residual Diuresis and Waste Products, as Oxalic Acid and Its Precursors
AU - Post Hospers, Gideon
AU - Visser, Wesley J
AU - Verhoeven, Jeroen G H P
AU - Laging, Mirjam
AU - Baart, Sara J
AU - Mertens Zur Borg, Ingrid R A M
AU - Hesselink, Dennis A
AU - de Mik-van Egmond, Anneke M E
AU - Betjes, Michiel G H
AU - van Agteren, Madelon
AU - Severs, David
AU - van de Wetering, Jacqueline
AU - Zietse, Robert
AU - Vos, Michel J
AU - Kema, Ido P
AU - Kho, Marcia M L
AU - Reinders, Marlies E J
AU - Roodnat, Joke I
N1 - Publisher Copyright:
Copyright © 2024 Post Hospers, Visser, Verhoeven, Laging, Baart, Mertens zur Borg, Hesselink, de Mik-van Egmond, Betjes, van Agteren, Severs, van de Wetering, Zietse, Vos, Kema, Kho, Reinders and Roodnat.
PY - 2024/7/19
Y1 - 2024/7/19
N2 - Delayed graft function (DGF) after kidney transplantation heralds a worse prognosis. In patients with hyperoxaluria, the incidence of DGF is high. Oxalic acid is a waste product that accumulates when kidney function decreases. We hypothesize that residual diuresis and accumulated waste products influence the DGF incidence. Patients transplanted between 2018-2022 participated in the prospective cohort study. Pre-transplant concentrations of oxalic acid and its precursors were determined. Data on residual diuresis and other recipient, donor or transplant related variables were collected. 496 patients were included, 154 were not on dialysis. Oxalic acid, and glyoxylic acid, were above upper normal concentrations in 98.8%, and 100% of patients. Residual diuresis was ≤150 mL/min in 24% of patients. DGF occurred in 157 patients. Multivariable binary logistic regression analysis demonstrated a significant influence of dialysis type, recipient BMI, donor type, age, and serum creatinine on the DGF risk. Residual diuresis and glycolic acid concentration were inversely proportionally related to this risk, glyoxylic acid directly proportionally. Results in the dialysis population showed the same results, but glyoxylic acid lacked significance. In conclusion, low residual diuresis is associated with increased DGF incidence. Possibly accumulated waste products also play a role. Pre-emptive transplantation may decrease the incidence of DGF.
AB - Delayed graft function (DGF) after kidney transplantation heralds a worse prognosis. In patients with hyperoxaluria, the incidence of DGF is high. Oxalic acid is a waste product that accumulates when kidney function decreases. We hypothesize that residual diuresis and accumulated waste products influence the DGF incidence. Patients transplanted between 2018-2022 participated in the prospective cohort study. Pre-transplant concentrations of oxalic acid and its precursors were determined. Data on residual diuresis and other recipient, donor or transplant related variables were collected. 496 patients were included, 154 were not on dialysis. Oxalic acid, and glyoxylic acid, were above upper normal concentrations in 98.8%, and 100% of patients. Residual diuresis was ≤150 mL/min in 24% of patients. DGF occurred in 157 patients. Multivariable binary logistic regression analysis demonstrated a significant influence of dialysis type, recipient BMI, donor type, age, and serum creatinine on the DGF risk. Residual diuresis and glycolic acid concentration were inversely proportionally related to this risk, glyoxylic acid directly proportionally. Results in the dialysis population showed the same results, but glyoxylic acid lacked significance. In conclusion, low residual diuresis is associated with increased DGF incidence. Possibly accumulated waste products also play a role. Pre-emptive transplantation may decrease the incidence of DGF.
UR - http://www.scopus.com/inward/record.url?scp=85200240615&partnerID=8YFLogxK
U2 - 10.3389/ti.2024.13218
DO - 10.3389/ti.2024.13218
M3 - Article
C2 - 39100754
SN - 0934-0874
VL - 37
JO - Transplant international : official journal of the European Society for Organ Transplantation
JF - Transplant international : official journal of the European Society for Organ Transplantation
M1 - 13218
ER -