Serum Alkaline Phosphatase Predicts Graft Failure and Mortality in Kidney Transplant Recipients.

Y. Kim,¹ S. Park,¹ S. Yang,² H. Lee,¹ Y. Kim,³ S.-K. Park,⁴ D. Han,³ I. Jung,⁵ J. Ha,⁶ C. Lim,⁷ Y. Kim,¹ J. Lee.⁷

¹Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
²Seoul National University Biomedical Research Institute, Seoul, Republic of Korea
³Division of Kidney Transplantation, Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
⁴Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
⁵Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
⁶Surgery, Seoul National University Hospital, Seoul, Republic of Korea
⁷Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea

Meeting: 2017 American Transplant Congress

Abstract number: D275

Keywords: Graft failure, Kidney transplantation, Prognosis

Session Information

Session Name: Poster Session D: Long Term Kidney Outcomes

Session Type: Poster Session

Date: Tuesday, May 2, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Objective: Recent studies showed that high levels of serum alkaline phosphatase (ALP) are associated with all-cause or cardiovascular death among hemodialysis patients. However, there are apparently no data on the effect of ALP in kidney transplant recipients. The aim of this study was to evaluate whether serum ALP is associated with graft failure and mortality after kidney transplantation

Methods: Among the 3029 kidney transplant recipients who were enrolled in a multicenter cohort from January 1, 1997 to December 1, 2012, we examined the association of pre-transplant serum ALP levels and graft failure and mortality.

Results: Pre-transplant serum ALP > 80 IU/L was associated with a hazard ratio (HR) for graft failure of 1.571 (95% CI 1.146-2.152, P = 0.005) in a fully adjusted model. Graft failure rate in kidney recipients gradually increased across 20 IU/L increments of ALP as compared with ALP < 60 IU/L (HR 60-80: 1.516, 95% CI 1.024-2.244, 80-100: 1.765, 95% CI 1.159-2685, 100-120: 1.972, 95% CI 1.211-3.213, 120-140: 2.2671 95% CI 1.373-3.741, > 140: 2.163, 95% CI 1.415-3.306). A rise in serum ALP by 40 IU/L during the first 3 months after kidney transplantation was associated with higher rates of graft failure (HR 2.353, 95% CI 1.506-3.676) and higher rates of mortality (HR: 2.733, 95% CI 1.479-5.050). Cox regression models using time-varying ALP demonstrated significant relationships between ALP and graft loss (HR 1.39, 95% CI 1.04-1.84) and mortality (HR 2.14, 95% CI 1.39-3.27).

Conclusion: Increased pre-transplant serum ALP and a rise in serum ALP after kidney transplantation is associated with graft failure and mortality in kidney transplant recipients.

CITATION INFORMATION: Kim Y, Park S, Yang S, Lee H, Kim Y, Park S.-K, Han D, Jung I, Ha J, Lim C, Kim Y, Lee J. Serum Alkaline Phosphatase Predicts Graft Failure and Mortality in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Kim Y, Park S, Yang S, Lee H, Kim Y, Park S-K, Han D, Jung I, Ha J, Lim C, Kim Y, Lee J. Serum Alkaline Phosphatase Predicts Graft Failure and Mortality in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/serum-alkaline-phosphatase-predicts-graft-failure-and-mortality-in-kidney-transplant-recipients/. Accessed May 29, 2025.

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