Kidney Week

Abstract: TH-OR127

Sclerostin Is an Independent Risk Factor of All-Cause Mortality in Older Kidney Transplant Recipients and Graft Loss in Younger Kidney Transplant Recipients

Session Information

• Predictors of Clinical Outcomes After Kidney Transplantation
  October 25, 2018 | Location: 6C, San Diego Convention Center
  Abstract Time: 05:42 PM - 05:54 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Zeng, Shufei, Charité University Berlin, Berlin, Germany

Shufei Zeng, MD



Shufei Zeng holds a Master degree of Medicine at Jinan University, Guangzhou, China. Now she is pursuing M.D degree at Charité University of Medicine in Berlin, Germany. Her research interest includes CKD-MBD biomarkers and renal fibrosis.

• Pommer, Wolfgang M., Charité University Berlin, Berlin, Germany

Wolfgang M. Pommer,

• Gaballa, Mohamed M.S., Institute of Nutritional Science University of Potsdam , Potsdam, Germany

Mohamed M.S. Gaballa,

• Hasan, Ahmed A., Institute of Nutritional Science University of Potsdam , Potsdam, Germany

Ahmed A. Hasan,

• Hocher, Berthold, University of Potsdam, Potsdam, Germany

Berthold Hocher,

Group or Team Name

• Institute of Nutritional Science University of Potsdam

Background

Immediate graft loss and patient survival after kidney transplantation have improved over the past decade, however, long-term outcomes remain an issue and graft loss is in some centers the leading cause for imitating renal replacement therapy. Sclerostin is a hormone contributing to the bone-vascular wall cross talk and has been implicated in cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, the relationship between sclerostin and mortality or graft failure in renal transplant recipients has not been analyzed so far.

Methods

600 stable renal transplant recipients were followed for 3 years for all-cause mortality and graft failure. Blood and urine samples for analysis of sclerostin, albumin, creatinine, total cholesterol, HbA1c, 1,25(OH)₂D, calcium, phosphorus, iPTH, fasting blood glucose, urinary protein and clinical data were collected at baseline. We performed Kaplan Meier survival analysis and Cox regressions models considering confounding factors such as eGFR, urinary protein excretion, cold ischemia time, donor age, recipient age, time on dialysis and HbA1c.

Results

Elevated baseline serum sclerostin concentrations (>75 ng/ml) is an independent risk factor for all-cause mortality in older(>66y) stable kidney transplant recipients but not in young patients: Kaplan-Meier curves (older patients: P=0.003, log-rank test; young patients: P=0.492, log-rank test); and Cox regression (older patients: relative risk, 0.155; 95% CI, 0.043 to 0.561 ; P=0.004; young patients: relative risk, 1.330; 95% CI, 0.170-10.403; P=0.786). Elevated baseline serum sclerostin concentrations (>75 ng/ml) is an independent risk factor for graft failure in young(≤66y) stable kidney transplant recipients but not in older patients: Kaplan-Meier Curves(older patients: P=0.784, log-rank test; young patients: P=0.023, log-rank test); and Cox regression (older patients: relative risk, 0.227; 95% CI, 0.011 to 4.855 ; P=0.343; young patients: relative risk, 0.244; 95% CI, 0.063-0.944; P=0.041).

Conclusion

Our study showed for the first time that elevated baseline serum sclerostin is an independent risk factor of all-cause mortality in older patients and for graft failure in young patients after kidney transplantation.