Kidney transplantation is a lifesaving procedure for patients suffering from end-stage renal disease. However, transplant outcomes can be challenging, and transplant loss or death is a significant concern for transplant recipients. A recent study has shed light on a potential biomarker that may be useful in predicting transplant outcomes and improving patient outcomes.
The study, published in Kidney Medicine, found that increased serum bicarbonate levels in kidney transplant recipients correlated with a reduced risk of transplant loss and death. This finding is significant because bicarbonate is a readily accessible and inexpensive biomarker that can be easily measured through routine blood tests.
Bicarbonate helps maintain a normal pH balance in the blood, which is important for overall health. The amount of dissolved CO2 in the blood is used to measure serum bicarbonate and check the acid-base balance. If CO2 is low in the blood, it means bicarbonate is low and the body has too much acid, resulting in metabolic acidosis. Normal serum bicarbonate levels in the blood range from 22 to 29 milliequivalents per liter (mEq/L).
Methodology
The study was a retrospective analysis of data from the Integrated Claims-Clinical dataset (Optum) of U.S. patients between 2007 and 2019. The authors included data from 1,915 adult kidney transplant recipients with a median follow-up of 2.5 years. The primary outcome of the study was death or transplant loss, and the authors used serum bicarbonate levels as a predictor of this outcome.
The authors adjusted for a number of potential confounders, including age, race, gender, diabetes status, and other factors known to affect transplant outcomes. They also analyzed the data based on the type of transplant (living vs. deceased donor) and the presence of other medical conditions.
Results
After a median follow-up of about 2.5 years, researchers saw a correlation between each 1-mEq/L increase in serum bicarbonate and a significantly lower risk of graft loss by 10%, death by 8%, major adverse cardiac events by 4%, and hospitalization by 8%.
Implications
The findings of this study have important implications for kidney transplant recipients and their healthcare providers. The results suggest that increased serum bicarbonate levels may be a useful biomarker for predicting transplant outcomes and guiding patient care.
For transplant recipients, monitoring bicarbonate levels and ensuring that they are on the upper end of the healthy range may be an important step in reducing the risk of transplant loss and death. For healthcare providers, measuring bicarbonate levels in kidney transplant recipients may provide valuable information about a patient’s risk for adverse transplant outcomes and guide clinical decision-making.
Conclusion
The results of this study suggest that increased serum bicarbonate levels may be a useful biomarker for predicting transplant outcomes and reducing the risk of transplant loss and death. Further research is needed to confirm these findings and to better understand the underlying mechanisms of this relationship. Nevertheless, the findings provide valuable information for kidney transplant recipients and their healthcare providers and highlight the importance of monitoring bicarbonate levels in this population.
Reference:
Mathur V, et al. Kidney Med. 2022;doi:10.1016/j.xkme.2022.100573.
