Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Drechsler, C; Pihlstrøm, H; Meinitzer, A; Pilz, S; Tomaschitz, A; Abedini, S; Fellstrom, B; Jardine, AG; Wanner, C; März, W; Holdaas, H.
Homoarginine and Clinical Outcomes in Renal Transplant Recipients: Results From the Assessment of Lescol in Renal Transplantation Study.
Transplantation. 2015; 99(7):1470-1476
Doi: 10.1097/TP.0000000000000568
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- März Winfried
- Meinitzer Andreas
- Pilz Stefan
- Tomaschitz Andreas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Despite improvements in kidney transplantation, complications, including cardiovascular morbidity and graft loss, contribute to reduced graft and patient survival. The amino acid homoarginine exerts a variety of beneficial effects that may be relevant for cardiovascular and graft outcomes, which is investigated in the present study. Homoarginine was measured in 829 renal transplant recipients participating in the placebo group of the Assessment of Lescol in Renal Transplantation study. Mean follow-up was 6.7 years. By Cox regression analyses, we determined hazard ratios (HRs) to reach prespecified, adjudicated endpoints according to baseline homoarginine levels: major adverse cardiovascular events (n = 103), cerebrovascular events (n = 53), graft failure or doubling of serum creatinine (n = 140), noncardiovascular mortality (n = 51), and all-cause mortality (n = 107). Patients mean age was 50 ± 11 years, homoarginine concentration was 1.96 ± 0.76 μmol/L, and 65% were men. Patients in the lowest homoarginine quartile (<1.40 μmol/L) had an adjusted 2.6-fold higher risk of cerebrovascular events compared to those in the highest quartile (>2.34 μmol/L) (HR, 2.56; 95% confidence interval [95% CI], 1.13-5.82). Similarly, the renal endpoint occurred at a significantly increased rate in the lowest homoarginine quartile (HR, 2.34; 95% CI, 1.36-4.02). For noncardiovascular and all-cause mortality, there was also increased risk associated with the lowest levels of homoarginine, with HRs of 4.34 (95% CI, 1.63-10.69) and 2.50 (95% CI, 1.38-4.55), respectively. Low homoarginine is strongly associated with cerebrovascular events, graft loss and progression of kidney failure and mortality in renal transplant recipients. Whether interventions with homoarginine supplementation improve clinical outcomes requires further evaluation.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Biomarkers - blood
- Cardiovascular Diseases - blood
- Cardiovascular Diseases - diagnosis
- Cardiovascular Diseases - etiology
- Cardiovascular Diseases - mortality
- Chi-Square Distribution -
- Creatinine - blood
- Disease Progression -
- Europe -
- Fatty Acids, Monounsaturated - therapeutic use
- Female -
- Fluvastatin -
- Graft Rejection - blood
- Graft Rejection - diagnosis
- Graft Rejection - etiology
- Graft Rejection - mortality
- Graft Survival -
- Homoarginine - blood
- Humans -
- Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
- Indoles - therapeutic use
- Kidney Transplantation - adverse effects
- Kidney Transplantation - mortality
- Male -
- Middle Aged -
- Multivariate Analysis -
- North America -
- Proportional Hazards Models -
- Prospective Studies -
- Renal Insufficiency - blood
- Renal Insufficiency - diagnosis
- Renal Insufficiency - etiology
- Renal Insufficiency - mortality
- Risk Factors -
- Time Factors -
- Treatment Outcome -