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SHR Neuro Krebs Kardio Lipid

Drechsler, C; Pihlstrøm, H; Meinitzer, A; Pilz, S; Tomaschitz, A; Abedini, S; Fellstrom, B; Jardine, AG; Wanner, C; März, W; Holdaas, H.
Homoarginine and Clinical Outcomes in Renal Transplant Recipients: Results From the Assessment of Lescol in Renal Transplantation Study.
Transplantation. 2015; 99(7):1470-1476 [OPEN ACCESS]
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Autor/innen der Med Uni Graz:
Maerz Winfried
Meinitzer Andreas
Pilz Stefan
Tomaschitz Andreas
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Abstract:
Despite improvements in kidney transplantation, complications, including cardiovascular morbidity and graft loss, contribute to reduced graft and patient survival. The amino acid homoarginine exerts a variety of beneficial effects that may be relevant for cardiovascular and graft outcomes, which is investigated in the present study. Homoarginine was measured in 829 renal transplant recipients participating in the placebo group of the Assessment of Lescol in Renal Transplantation study. Mean follow-up was 6.7 years. By Cox regression analyses, we determined hazard ratios (HRs) to reach prespecified, adjudicated endpoints according to baseline homoarginine levels: major adverse cardiovascular events (n = 103), cerebrovascular events (n = 53), graft failure or doubling of serum creatinine (n = 140), noncardiovascular mortality (n = 51), and all-cause mortality (n = 107). Patients mean age was 50 ± 11 years, homoarginine concentration was 1.96 ± 0.76 μmol/L, and 65% were men. Patients in the lowest homoarginine quartile (<1.40 μmol/L) had an adjusted 2.6-fold higher risk of cerebrovascular events compared to those in the highest quartile (>2.34 μmol/L) (HR, 2.56; 95% confidence interval [95% CI], 1.13-5.82). Similarly, the renal endpoint occurred at a significantly increased rate in the lowest homoarginine quartile (HR, 2.34; 95% CI, 1.36-4.02). For noncardiovascular and all-cause mortality, there was also increased risk associated with the lowest levels of homoarginine, with HRs of 4.34 (95% CI, 1.63-10.69) and 2.50 (95% CI, 1.38-4.55), respectively. Low homoarginine is strongly associated with cerebrovascular events, graft loss and progression of kidney failure and mortality in renal transplant recipients. Whether interventions with homoarginine supplementation improve clinical outcomes requires further evaluation.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Biomarkers - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - etiology
Cardiovascular Diseases - mortality
Chi-Square Distribution -
Creatinine - blood
Disease Progression -
Europe -
Fatty Acids, Monounsaturated - therapeutic use
Female -
Fluvastatin -
Graft Rejection - blood
Graft Rejection - diagnosis
Graft Rejection - etiology
Graft Rejection - mortality
Graft Survival -
Homoarginine - blood
Humans -
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Indoles - therapeutic use
Kidney Transplantation - adverse effects
Kidney Transplantation - mortality
Male -
Middle Aged -
Multivariate Analysis -
North America -
Proportional Hazards Models -
Prospective Studies -
Renal Insufficiency - blood
Renal Insufficiency - diagnosis
Renal Insufficiency - etiology
Renal Insufficiency - mortality
Risk Factors -
Time Factors -
Treatment Outcome -

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