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Clinical impact of serum bilirubin levels on kidney transplant outcomes
Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantatio...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994407/ https://www.ncbi.nlm.nih.gov/pubmed/33767325 http://dx.doi.org/10.1038/s41598-021-86330-y |
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author | Lee, Juhan Kim, Eun Jin Lee, Jae Geun Kim, Beom Seok Huh, Kyu Ha Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Joo, Dong Jin |
author_facet | Lee, Juhan Kim, Eun Jin Lee, Jae Geun Kim, Beom Seok Huh, Kyu Ha Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Joo, Dong Jin |
author_sort | Lee, Juhan |
collection | PubMed |
description | Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes. |
format | Online Article Text |
id | pubmed-7994407 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-79944072021-03-29 Clinical impact of serum bilirubin levels on kidney transplant outcomes Lee, Juhan Kim, Eun Jin Lee, Jae Geun Kim, Beom Seok Huh, Kyu Ha Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Joo, Dong Jin Sci Rep Article Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes. Nature Publishing Group UK 2021-03-25 /pmc/articles/PMC7994407/ /pubmed/33767325 http://dx.doi.org/10.1038/s41598-021-86330-y Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Lee, Juhan Kim, Eun Jin Lee, Jae Geun Kim, Beom Seok Huh, Kyu Ha Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Joo, Dong Jin Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title | Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title_full | Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title_fullStr | Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title_full_unstemmed | Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title_short | Clinical impact of serum bilirubin levels on kidney transplant outcomes |
title_sort | clinical impact of serum bilirubin levels on kidney transplant outcomes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994407/ https://www.ncbi.nlm.nih.gov/pubmed/33767325 http://dx.doi.org/10.1038/s41598-021-86330-y |
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