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Impact of Postoperative Serum Chloride Changes on Graft Function and Acute Rejection in Recipients of Living Kidney Transplants

V. Vakil, D. Keys, M. Junghare, S. Jackson, D. Berglund, A. Matas, S. Riad.

U of MN, Minneapolis.

Meeting: 2018 American Transplant Congress

Abstract number: A205

Keywords: Glomerular filtration rate (GFR), Graft function, Kidney transplantation, Rejection

Session Information

Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Background: In the non-transplant setting, hyperchloremia has been associated with kidney injury. We sought to study the impact of serum chloride (SCl) on transplant outcomes.

Methods: We analyzed 936 living donor kidney transplants (LDKT) between '05-'17. A SCl on the day of transplant was compared to the SCl post-operative day 2 (POD2). The outcomes were 30-day eGFR and cellular rejection (ACR) within 90 days. A multivariate Cox Proportional Hazards model was performed. A multivariate linear regression was used to predict 30-day eGFR based on change in SCl.

Results: The average change in SCl on POD2 was an increase by 1.29 (0.95-1.64). Increasing SCl levels (from day of transplant to POD2) were associated with a decreased risk of 90-day ACR HR 0.92 (0.88-0.95, p<0.01). Additionally, 30-day eGFR increased by 0.45ml/min/1.73m2 (0.13-0.77, p=0.01) for each 1 unit increase in SCl on POD2.

Conclusion: A postoperative SCl increase was not associated with deleterious outcome in LDKT.

Baseline Characteristics

↓ SCl (n=363) ↑ SCl (n=502) No Change in SCl (n=71) P Value
Age 50.8 47.2 49.1 <0.01
Male % 63.4 65.3 62.0 0.76
White % 90.9 87.5 91.5 0.22
BMI 26.9 26.6 27.3 0.55
Prior Tx 14.6 15.1 9.9 0.50
DM % 35.5 31.5 28.2 0.31
PRA I % 0.41
0-19 83.3 86.6 85.5
20-74 14.4 10.8 14.5
75+ 2.3 2.4 0
PRA II % 0.06
0-19 87.0 82.6 83.8
20-74 8.9 15.2 11.8
75+ 4.0 2.2 4.4

CITATION INFORMATION: Vakil V., Keys D., Junghare M., Jackson S., Berglund D., Matas A., Riad S. Impact of Postoperative Serum Chloride Changes on Graft Function and Acute Rejection in Recipients of Living Kidney Transplants Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Vakil V, Keys D, Junghare M, Jackson S, Berglund D, Matas A, Riad S. Impact of Postoperative Serum Chloride Changes on Graft Function and Acute Rejection in Recipients of Living Kidney Transplants [abstract]. https://atcmeetingabstracts.com/abstract/impact-of-postoperative-serum-chloride-changes-on-graft-function-and-acute-rejection-in-recipients-of-living-kidney-transplants/. Accessed May 16, 2025.

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