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논문분류	춘계학술대회 초록집
제목	Serum bicarbonate and long-term outcomes in kidney transplant recipients
저자	Seokwoo Park* 1, Sehoon Park1, Seung Hee Yang2, Chun Soo Lim3, Yon Su Kim1, Young Hoon Kim4, Jung Pyo Lee3
출판정보	2016; 2016(1):
키워드	Transplant
초록	Background: Metabolic acidosis indicated by low serum bicarbonate (TCO2) level has been known as a risk factor for mortality and progressive renal dysfunction in patients with chronic kidney disease. Nevertheless, studies concerned with the effect of metabolic acidosis in kidney transplant recipients (KTRs) are scarse. Methods: We analyzed 3,117 adult KTRs between 1997 and 2012. Participants were categorized into low (less than 22 mEq/L) versus high TCO2 group based on serum TCO2 level at 3 and 6 months posttransplant. All-cause mortality and graft failure rate between different TCO2 level groups were compared. Results: Significant increase in all-cause mortality was observed in patients with low TCO2 level at three (P = 0.001) and six months (P = 0.004) compared to those with high TCO2 level. After adjustment for several factors including age, sex, diabetes, hypertension, relation with kidney donor, transplant era, estimated glomerular filtration rate, and history of acute rejection, low serum TCO2 level at three (HR 2.04, 95% CI 1.28, 3.26) and six months (HR 2.08, 95% CI 1.12, 3.85) was associated with increased hazards for death. Also, participants in low TCO2 group at three (HR 1.67, 95% CI 1.20, 2.31) and six months (HR 1.51, 95% CI 1.03, 2.23) were more likely to experience graft failure. Conclusion: Low TCO2 level can be a predictor of increased mortality and graft failure among KTRs irrespective of glomerular filtration rate. Further investigation is needed to evaluate the effect of metabolic acidosis and benefit of bicarbonate supplementation in KTRs.
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