Nutritional Status and Body Composition in Renal Transplant Recipients: A Two Year Follow Up

Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2–6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08–1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.

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Malignant and Noninvasive Skin Tumours in Renal Transplant Recipients

Dermatology Research and Practice ◽

10.1155/2014/409058 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Christopher D. Roche ◽

Joelle S. Dobson ◽

Sion K. Williams ◽

Mara Quante ◽

Joyce Popoola ◽

...

Keyword(s):

Renal Transplant ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Skin Tumours ◽

Skin Malignancy ◽

Increased Risk ◽

Malignant Skin ◽

Risk Of Malignancy

Background.Transplant recipients require immunosuppression to prevent graft rejection. This conveys an increased risk of malignancy, particularly skin tumours. There is a need for up-to-date data for the South of England.Method.Pathology records were reviewed for 709 kidney transplant recipients on immunosuppression at our hospital from 1995 to 2008. Skin tumours were recorded/analysed.Results.Mean age at transplant was 46 years. Mean length of follow-up was 7.2 years and total follow-up was 4926 person-years. 53 (7.5%) patients (39/458 (8.5%) males and 14/251 (5.6%) females) developed ≥1 skin malignancy. Cumulative incidences of 4.0%, 7.5%, and 12.2% were observed for those with <5, <10, and ≥10 years follow-up, respectively. The rate was 45 tumours per 1000 person-years at risk. Additionally, 21 patients (3.0%) only had noninvasive tumours. 221 malignant skin tumours were found: 50.2% were SCCs, 47.1% BCCs, and 2.7% malignant melanomas. Mean years to first tumour were 5.8. Mean number of tumours per patient was 4, with mean interval of 12 months.Conclusions.Despite changes in transplantation practice during the time since the last data were published in this region, these findings are similar to previous studies. This adds to the evidence allowing clinicians to inform patients in this region of their risk.

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The Course of Hepatitis C Virus Infection in Pretransplantation Anti–Hepatitis C Virus–Negative Renal Transplant Recipients: A Retrospective Follow-Up Study

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2005.11.008 ◽

2006 ◽

Vol 47 (2) ◽

pp. 309-316 ◽

Cited By ~ 32

Author(s):

Ioanna Delladetsima ◽

Mina Psichogiou ◽

Vana Sypsa ◽

Erasmia Psimenou ◽

Alkiviadis Kostakis ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Renal Transplant ◽

Virus Infection ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Hepatitis C Virus Infection ◽

Follow Up Study

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Urinary Excretion of N1-methyl-2-pyridone-5-carboxamide and N1-methylnicotinamide in Renal Transplant Recipients and Donors

Journal of Clinical Medicine ◽

10.3390/jcm9020437 ◽

2020 ◽

Vol 9 (2) ◽

pp. 437 ◽

Cited By ~ 2

Author(s):

Carolien P. J. Deen ◽

Anna van der Veen ◽

António W. Gomes-Neto ◽

Johanna M. Geleijnse ◽

Karin J. Borgonjen-van den Berg ◽

...

Keyword(s):

Renal Transplant ◽

Nutritional Status ◽

Urinary Excretion ◽

Kidney Function ◽

Density Lipoprotein ◽

Kidney Donation ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Cross Sectional ◽

Kidney Donors

N1-methylnicotinamide (N1-MN) and N1-methyl-2-pyridone-5-carboxamide (2Py) are successive end products of NAD+ catabolism. N1-MN excretion in 24-h urine is the established biomarker of niacin nutritional status, and recently shown to be reduced in renal transplant recipients (RTR). However, it is unclear whether 2Py excretion is increased in this population, and, if so, whether a shift in excretion of N1-MN to 2Py can be attributed to kidney function. Hence, we assessed the 24-h urinary excretion of 2Py and N1-MN in RTR and kidney donors before and after kidney donation, and investigated associations of the urinary ratio of 2Py to N1-MN (2Py/N1-MN) with kidney function, and independent determinants of urinary 2Py/N1-MN in RTR. The urinary excretion of 2Py and N1-MN was measured in a cross-sectional cohort of 660 RTR and 275 healthy kidney donors with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear regression analyses were used to investigate associations and determinants of urinary 2Py/N1-MN. Median 2Py excretion was 178.1 (130.3–242.8) μmol/day in RTR, compared to 155.6 (119.6–217.6) μmol/day in kidney donors (p < 0.001). In kidney donors, urinary 2Py/N1-MN increased significantly after kidney donation (4.0 ± 1.4 to 5.2 ± 1.5, respectively; p < 0.001). Smoking, alcohol consumption, diabetes, high-density lipoprotein (HDL), high-sensitivity C-reactive protein (hs-CRP) and estimated glomerular filtration rate (eGFR) were identified as independent determinants of urinary 2Py/N1-MN in RTR. In conclusion, the 24-h urinary excretion of 2Py is higher in RTR than in kidney donors, and urinary 2Py/N1-MN increases after kidney donation. As our data furthermore reveal strong associations of urinary 2Py/N1-MN with kidney function, interpretation of both N1-MN and 2Py excretion may be recommended for assessment of niacin nutritional status in conditions of impaired kidney function.

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