Nitric oxide and long-term outcomes after kidney transplantation: Results of the TransplantLines cohort study

Hanno Maassen, M Yusof Said, Anne-Roos S Frenay, Anne Koning, Adrian Post, Ineke J Riphagen, M Rebecca Heiner-Fokkema, Kathrin Drabert, Bernadette O Fernandez, Reinold O B Gans, Else van den Berg, Gerjan Navis, Dimitrios Tsikas, Martin Feelisch, Stephan J L Bakker, Harry van Goor*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Impaired endogenous nitric oxide (NO) production may contribute to graft failure and premature mortality in kidney transplant recipients (KTR). We investigated potential associations of 24-h urinary NOx (NO3- + NO2-) excretion (uNOx) with long-term outcomes. uNOx was determined by HPLC and GC-MS in 698 KTR and in 132 kidney donors before and after donation. Additionally, we measured urinary nitroso species (RXNO) by gas-phase chemiluminescence. Median uNOx was lower in KTR compared to kidney donors (688 [393-1076] vs. 1301 [868-1863] before donation and 1312 [982-1853] μmol/24 h after donation, P < 0.001). During median follow-up of 5.4 [4.8-6.1] years, 150 KTR died (61 due to cardiovascular disease) and 83 experienced graft failure. uNOx was inversely associated with all-cause mortality (HR per doubling of uNOx: 0.84 [95% CI 0.75-0.93], P < 0.001) and cardiovascular mortality (HR 0.78 [95% CI 0.67-0.92], P = 0.002). The association of uNOx with graft failure was lost when adjusted for renal function (HR per doubling of uNOx: 0.89 [95% CI 0.76-1.05], P = 0.17). There were no significant associations of urinary RXNO with outcomes. Our study suggests that KTR have lower NO production than healthy subjects and that lower uNOx is associated with a higher risk of all-cause and cardiovascular mortality.

Originele taal-2English
Pagina's (van-tot)1-11
Aantal pagina's11
TijdschriftNitric oxide-Biology and chemistry
Vroegere onlinedatum2-jun-2022
StatusPublished - 1-aug-2022

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