Clinical impact of serum bilirubin levels on kidney transplant outcomes

Abstract Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney trans...

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Autores principales:	Juhan Lee, Eun Jin Kim, Jae Geun Lee, Beom Seok Kim, Kyu Ha Huh, Myoung Soo Kim, Soon Il Kim, Yu Seun Kim, Dong Jin Joo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/70842599fef24e85b7a2150b643b33f2
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spelling	oai:doaj.org-article:70842599fef24e85b7a2150b643b33f22021-12-02T16:36:05ZClinical impact of serum bilirubin levels on kidney transplant outcomes10.1038/s41598-021-86330-y2045-2322https://doaj.org/article/70842599fef24e85b7a2150b643b33f22021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86330-yhttps://doaj.org/toc/2045-2322Abstract Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes.Juhan LeeEun Jin KimJae Geun LeeBeom Seok KimKyu Ha HuhMyoung Soo KimSoon Il KimYu Seun KimDong Jin JooNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juhan Lee Eun Jin Kim Jae Geun Lee Beom Seok Kim Kyu Ha Huh Myoung Soo Kim Soon Il Kim Yu Seun Kim Dong Jin Joo Clinical impact of serum bilirubin levels on kidney transplant outcomes
description	Abstract Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3–12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.64, 95% CI 1.67–4.18, P < 0.001), death-censored graft failure (HR 2.97, 95% CI 1.63–5.42, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01–4.22, P = 0.046). Patients with lower serum bilirubin were also at greater risk of rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes.
format	article
author	Juhan Lee Eun Jin Kim Jae Geun Lee Beom Seok Kim Kyu Ha Huh Myoung Soo Kim Soon Il Kim Yu Seun Kim Dong Jin Joo
author_facet	Juhan Lee Eun Jin Kim Jae Geun Lee Beom Seok Kim Kyu Ha Huh Myoung Soo Kim Soon Il Kim Yu Seun Kim Dong Jin Joo
author_sort	Juhan Lee
title	Clinical impact of serum bilirubin levels on kidney transplant outcomes
title_short	Clinical impact of serum bilirubin levels on kidney transplant outcomes
title_full	Clinical impact of serum bilirubin levels on kidney transplant outcomes
title_fullStr	Clinical impact of serum bilirubin levels on kidney transplant outcomes
title_full_unstemmed	Clinical impact of serum bilirubin levels on kidney transplant outcomes
title_sort	clinical impact of serum bilirubin levels on kidney transplant outcomes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/70842599fef24e85b7a2150b643b33f2
work_keys_str_mv	AT juhanlee clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT eunjinkim clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT jaegeunlee clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT beomseokkim clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT kyuhahuh clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT myoungsookim clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT soonilkim clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT yuseunkim clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes AT dongjinjoo clinicalimpactofserumbilirubinlevelsonkidneytransplantoutcomes
_version_	1718383639071293440

Clinical impact of serum bilirubin levels on kidney transplant outcomes

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