Kidney Week

Abstract: PO2110

Boron Exposure and Decreased Risk of Mortality in Kidney Transplant Recipients

Session Information

• Transplantation: Clinical - Allocation, Evaluation, Prognosis, and Viral Onslaughts
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Kremer, Daan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Daan Kremer, MD

• Post, Adrian, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Adrian Post,

• Seidel, Ulrike, Christian-Albrechts-Universitat zu Kiel, Kiel, Schleswig-Holstein, Germany

Ulrike Seidel,

• van der Veen, Yvonne, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Yvonne van der Veen,

• Groothof, Dion, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Dion Groothof,

• Gomes Neto, Antonio Wouter, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Antonio Wouter Gomes Neto,

• Knobbe, Tim J., Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Tim J. Knobbe,

• Rimbach, Gerald, Christian-Albrechts-Universitat zu Kiel, Kiel, Schleswig-Holstein, Germany

Gerald Rimbach,

• Bakker, Stephan J.L., Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Stephan J.L. Bakker,

Group or Team Name

• TransplantLines Investigators

Background

In a search for potential modifiable factors to improve long-term outcome among kidney transplant recipients (KTR), we studied dietary patterns in the Blue Zones, and hypothesized that boron exposure is associated with improved long-term outcome in KTR.

Methods

We determined 24h urinary boron excretion using inductively coupled plasma mass-spectrometry as a measure of boron intake in 693 stable KTR (57% male, mean age 53y), enrolled in the TransplantLines F&N Biobank and Cohort Study. Dietary intake was assessed using validated food-frequency questionnaires.

Results

Linear regression analyses showed that dietary intake of fruit, wine and nuts were key determinants of boron excretion. In contrast, boron excretion was negatively associated with homocysteine and inflammation parameters. In total, 73 (32%), 47 (20%) and 30 (13%) patients died among the lowest, middle and highest tertiles of boron, respectively (P_log-rank <0.001). Cox regression analyses showed that high boron excretion was strongly associated with lower risk of mortality, independent of age, sex, eGFR and history of cardiovascular disease (HR per doubling: 0.51, 95%CI:0.40 to 0.66, P<0.001, Figure), and other potential clinical and dietary confounders.

Conclusion

Boron may be an overlooked target to improve long-term outcome among KTR and potentially other patients, partly through suggested beneficial effects on inflammation, the methionine-homocysteine cycle, and ageing processes. Interventional trials are warranted to confirm the potential of dietary boron supplementation in KTR and other patient populations.

Associations of urinary boron excretion with risk of all-cause mortality, based on a Cox proportional hazards regression model adjusted for age, sex, eGFR, and history of cardiovascular disease, presented in relation to the histogram of urinary boron excretion.

Funding

• Clinical Revenue Support