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Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients

It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of N(1)-methylnicotinamide (N(1)-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortali...

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Autores principales: Deen, Carolien P.J., van der Veen, Anna, Gomes-Neto, António W., Geleijnse, Johanna M., Borgonjen-van den Berg, Karin J., Heiner-Fokkema, M. Rebecca, Kema, Ido P., Bakker, Stephan J.L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400946/
https://www.ncbi.nlm.nih.gov/pubmed/32664445
http://dx.doi.org/10.3390/nu12072059
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author Deen, Carolien P.J.
van der Veen, Anna
Gomes-Neto, António W.
Geleijnse, Johanna M.
Borgonjen-van den Berg, Karin J.
Heiner-Fokkema, M. Rebecca
Kema, Ido P.
Bakker, Stephan J.L.
author_facet Deen, Carolien P.J.
van der Veen, Anna
Gomes-Neto, António W.
Geleijnse, Johanna M.
Borgonjen-van den Berg, Karin J.
Heiner-Fokkema, M. Rebecca
Kema, Ido P.
Bakker, Stephan J.L.
author_sort Deen, Carolien P.J.
collection PubMed
description It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of N(1)-methylnicotinamide (N(1)-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of N(1)-MN to N(1)-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both N(1)-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of N(1)-MN and 2Py (N(1)-MN + 2Py), and its associations with risk of premature mortality in KTR. N(1)-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of N(1)-MN + 2Py excretion were investigated with Cox regression analyses. Median N(1)-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. N(1)-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; p < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; p = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of N(1)-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of N(1)-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR.
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spelling pubmed-74009462020-08-07 Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients Deen, Carolien P.J. van der Veen, Anna Gomes-Neto, António W. Geleijnse, Johanna M. Borgonjen-van den Berg, Karin J. Heiner-Fokkema, M. Rebecca Kema, Ido P. Bakker, Stephan J.L. Nutrients Article It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of N(1)-methylnicotinamide (N(1)-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of N(1)-MN to N(1)-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both N(1)-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of N(1)-MN and 2Py (N(1)-MN + 2Py), and its associations with risk of premature mortality in KTR. N(1)-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of N(1)-MN + 2Py excretion were investigated with Cox regression analyses. Median N(1)-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. N(1)-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; p < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; p = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of N(1)-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of N(1)-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR. MDPI 2020-07-10 /pmc/articles/PMC7400946/ /pubmed/32664445 http://dx.doi.org/10.3390/nu12072059 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deen, Carolien P.J.
van der Veen, Anna
Gomes-Neto, António W.
Geleijnse, Johanna M.
Borgonjen-van den Berg, Karin J.
Heiner-Fokkema, M. Rebecca
Kema, Ido P.
Bakker, Stephan J.L.
Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title_full Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title_fullStr Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title_full_unstemmed Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title_short Urinary Excretion of N(1)-Methylnicotinamide and N(1)-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
title_sort urinary excretion of n(1)-methylnicotinamide and n(1)-methyl-2-pyridone-5-carboxamide and mortality in kidney transplant recipients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400946/
https://www.ncbi.nlm.nih.gov/pubmed/32664445
http://dx.doi.org/10.3390/nu12072059
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