Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study

Sotomayor, Camilo G.; Groothof, Dion; Vodegel, Joppe J.; Gacitúa, Tomás A.; Gomes-Neto, António W.; Osté, Maryse C. J.; Pol, Robert A.; Ferreccio, Catterina; Berger, Stefan P.; Chong, Guillermo; Slart, Riemer H. J. A.; Rodrigo, Ramón; Navis, Gerjan J.; Touw, Daan J.; Bakker, Stephan J. L.

doi:10.3390/jcm9020417

Open AccessArticle

Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study

by

Camilo G. Sotomayor

^1,*,†

,

Dion Groothof

^1,†

,

Joppe J. Vodegel

¹

,

Tomás A. Gacitúa

¹,

António W. Gomes-Neto

¹

,

Maryse C. J. Osté

¹

,

Robert A. Pol

²,

Catterina Ferreccio

³,

Stefan P. Berger

¹,

Guillermo Chong

⁴,

Riemer H. J. A. Slart

⁵,

Ramón Rodrigo

⁶

,

Gerjan J. Navis

¹,

Daan J. Touw

⁷ and

Stephan J. L. Bakker

¹

Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

²

Division of Transplantation Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

³

Advanced Center for Chronic Diseases, Pontificia Universidad Católica de Chile, 8330033 Santiago, Chile

⁴

Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, 7610658 Santiago, Chile

⁵

Department of Nuclear and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

⁶

Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, CP 8380453 Santiago, Chile

⁷

Department of Pharmacy and Clinical Pharmacology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Clin. Med. 2020, 9(2), 417; https://doi.org/10.3390/jcm9020417

Submission received: 31 December 2019 / Revised: 26 January 2020 / Accepted: 31 January 2020 / Published: 3 February 2020

(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Kidney Transplantation)

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Abstract

Arsenic is toxic to many organ systems, the kidney being the most sensitive target organ. We aimed to investigate whether, in kidney transplant recipients (KTRs), the nephrotoxic exposure to arsenic could represent an overlooked hazard for graft survival. We performed a prospective cohort study of 665 KTRs with a functional graft ≥1 year, recruited in a university setting (2008‒2011), in The Netherlands. Plasma arsenic was measured by ICP-MS, and dietary intake was comprehensively assessed using a validated 177-item food-frequency questionnaire. The endpoint graft failure was defined as restart of dialysis or re-transplantation. Median arsenic concentration was 1.26 (IQR, 1.04‒2.04) µg/L. In backwards linear regression analyses we found that fish consumption (std β = 0.26; p < 0.001) was the major independent determinant of plasma arsenic. During 5 years of follow-up, 72 KTRs developed graft failure. In Cox proportional-hazards regression analyses, we found that arsenic was associated with increased risk of graft failure (HR 1.80; 95% CI 1.28–2.53; p = 0.001). This association remained materially unaltered after adjustment for donor and recipient characteristics, immunosuppressive therapy, eGFR, primary renal disease, and proteinuria. In conclusion, in KTRs, plasma arsenic is independently associated with increased risk of late graft failure.

Keywords: arsenic; diet; fish consumption; oxidative stress; kidney transplantation; graft failure

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MDPI and ACS Style

Sotomayor, C.G.; Groothof, D.; Vodegel, J.J.; Gacitúa, T.A.; Gomes-Neto, A.W.; Osté, M.C.J.; Pol, R.A.; Ferreccio, C.; Berger, S.P.; Chong, G.; et al. Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study. J. Clin. Med. 2020, 9, 417. https://doi.org/10.3390/jcm9020417

AMA Style

Sotomayor CG, Groothof D, Vodegel JJ, Gacitúa TA, Gomes-Neto AW, Osté MCJ, Pol RA, Ferreccio C, Berger SP, Chong G, et al. Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study. Journal of Clinical Medicine. 2020; 9(2):417. https://doi.org/10.3390/jcm9020417

Chicago/Turabian Style

Sotomayor, Camilo G., Dion Groothof, Joppe J. Vodegel, Tomás A. Gacitúa, António W. Gomes-Neto, Maryse C. J. Osté, Robert A. Pol, Catterina Ferreccio, Stefan P. Berger, Guillermo Chong, and et al. 2020. "Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study" Journal of Clinical Medicine 9, no. 2: 417. https://doi.org/10.3390/jcm9020417

APA Style

Sotomayor, C. G., Groothof, D., Vodegel, J. J., Gacitúa, T. A., Gomes-Neto, A. W., Osté, M. C. J., Pol, R. A., Ferreccio, C., Berger, S. P., Chong, G., Slart, R. H. J. A., Rodrigo, R., Navis, G. J., Touw, D. J., & Bakker, S. J. L. (2020). Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study. Journal of Clinical Medicine, 9(2), 417. https://doi.org/10.3390/jcm9020417

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Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study

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