Serum Bicarbonate and Long-Term Outcomes in Kidney Transplant Recipients.

S. Park,¹ E. Kang,¹ M. Han,¹ J. Park,¹ S. Yang,² S. Park,³ I. Jung,⁴ C. Lim,⁵ Y. Kim,¹ Y. Kim,⁶ J. Lee.⁵

¹Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
²Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
³Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
⁴Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
⁵Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
⁶Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.

Meeting: 2016 American Transplant Congress

Abstract number: 342

Keywords: Graft failure, Kidney transplantation, Metabolic complications, Mortality

Session Information

Session Name: Concurrent Session: Metabolic Complications in Kidney Transplantation

Session Type: Concurrent Session

Date: Monday, June 13, 2016

Session Time: 4:30pm-6:00pm

Presentation Time: 5:06pm-5:18pm

Location: Room 312

Background: Metabolic acidosis indicated by low serum bicarbonate (TCO2) level has been known as a risk factor for mortality and progressive renal dysfunction in patients with chronic kidney disease. Nevertheless, studies concerned with the effect of metabolic acidosis in kidney transplant recipients (KTRs) are scarse.

Methods: We analyzed 3,117 adult KTRs between 1997 and 2012. Participants were categorized into low (less than 22 mEq/L) versus high TCO2 group based on serum TCO2 level at 3 and 6 months posttransplant. All-cause mortality and graft failure rate between different TCO2 level groups were compared.

Results: Significant increase in all-cause mortality was observed in patients with low TCO2 level at three (P = 0.001) and six months (P = 0.004) compared to those with high TCO2 level. After adjustment for several factors including age, sex, diabetes, hypertension, relation with kidney donor, transplant era, estimated glomerular filtration rate, and history of acute rejection, low serum TCO2 level at three (HR 2.04, 95% CI 1.28, 3.26) and six months (HR 2.08, 95% CI 1.12, 3.85) was associated with increased hazards for death. Also, participants in low TCO2 group at three (HR 1.67, 95% CI 1.20, 2.31) and six months (HR 1.51, 95% CI 1.03, 2.23) were more likely to experience graft failure.

Conclusion: Low TCO2 level can be a predictor of increased mortality and graft failure among KTRs irrespective of glomerular filtration rate. Further investigation is needed to evaluate the effect of metabolic acidosis and benefit of bicarbonate supplementation in KTRs.

CITATION INFORMATION: Park S, Kang E, Han M, Park J, Yang S, Park S, Jung I, Lim C, Kim Y, Kim Y, Lee J. Serum Bicarbonate and Long-Term Outcomes in Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Park S, Kang E, Han M, Park J, Yang S, Park S, Jung I, Lim C, Kim Y, Kim Y, Lee J. Serum Bicarbonate and Long-Term Outcomes in Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/serum-bicarbonate-and-long-term-outcomes-in-kidney-transplant-recipients/. Accessed May 11, 2025.

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