Kidney Week

Abstract: SU-OR48

Albuminuria in Kidney Transplantation Patients Predicts Cardiovascular Morbidity After Two Years

Session Information

• Challenges in Clinical Transplantation
  October 25, 2020 | Location: Simulive
  Abstract Time: 05:00 PM - 07:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Bielopolski, Dana, The Rockefeller University, New York, United States

Dana Bielopolski, MD, PhD



Dr. Dana Bielopolski received her MD and PhD from the Sackler School of Medicine, Tel Aviv University in Israel. She completed her internal medicine residency and nephrology fellowship at Rabin Medical Center in Israel. Her current position since July 2019 is an Instructor in Clinical Investigations at the Rockefeller University in New York. She is leading both a clinical trial and big data analysis, two projects that are linked by the common aspect of hypertension prevention and early diagnosis of kidney long term consequences. In 2020 she received the NKF Young Investigator award.

• Rahamimov, Ruth, Rabin Medical Center, Petah Tikva, Israel

Ruth Rahamimov,

• Zingerman, Boris, Rabin Medical Center, Petah Tikva, Israel

Boris Zingerman,

• Chagnac, Avry, Rabin Medical Center, Petah Tikva, Israel

Avry Chagnac,

• Azulay gitter, Limor, Rabin Medical Center, Petah Tikva, Israel

Limor Azulay gitter,

• Rozen-zvi, Benaya, Rabin Medical Center, Petah Tikva, Israel

Benaya Rozen-zvi,

Background

Moderately Increased Albuminuria (MIA) is a well characterized marker of kidney malfunction, both in diabetic and non-diabetic populations, and is used as a prognostic marker for cardiovascular morbidity and mortality. A few studies implied that it has the same value in kidney transplanted patients, but the information relies on spot or dipstick urine protein evaluations, rather than the gold standard of timed urine collection.

Methods

We revisited a cohort of 286 kidney transplanted patients, several years after completing a meticulously timed urine collection and assessed the prevalence of major cardiovascular adverse events (MACE) in relation to albuminuria.

Results

During a median follow up of 8.3 years (IQR 6.4-9.1) 144 outcome events occurred in 101 patients. By Kaplan-Meier analysis MIA was associated with increased rate of CV outcome or death (p=0.03), and this was still significant after stratification according to propensity score quartiles (p=0.048). Time dependent Cox proportional hazard analysis showed independent association between MIA and CV outcomes two years following MIA detection (HR 1.83, 95% CI 1.07-2.96).

Conclusion

Two years after documenting MIA in kidney transplanted patients, their CVD risk was increased, most likely, as a result of endothelial dysfunction. This should prompt the caregiver for strict primary prevention and risk factors modification.

Kaplan-Meier analysis showing rate of CV outcome or death in relation to MIA. X axis shows days since urine collection, Y axis shows cumulative survival. Blue curve – patients without MIA, red curve – patients with MIA.