Jang Yunyoung, Park Seokwoo, Lee Hajeong, Kim Young-Hoon, Lee Jung Pyo, Park Su-Kil, Jung In Mok, Ha Jongwon, Lim Chun Soo, Kim Yon Su, Kwon Hyunwook, Kim Yong Chul
Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
Transplant Proc. 2022 Apr;54(3):678-684. doi: 10.1016/j.transproceed.2022.02.001. Epub 2022 Mar 9.
Recent studies have shown that high levels of serum alkaline phosphatase (ALP) are associated with all-cause and cardiovascular death among patients undergoing hemodialysis. However, there is limited knowledge on the effect of ALP level in kidney transplant recipients (KTRs). The aim of this study was to evaluate if serum ALP levels before and after transplant and the changes in ALP levels are associated with graft failure and mortality.
Between January 1997 and December 2012, 3029 KTRs were enrolled in a multicenter cohort. We examined the association of pre- and posttransplant serum ALP levels and long-term outcomes in KTRs.
Pretransplant serum ALP level >80 IU/L was associated with a hazard ratio (HR) for graft failure of 1.571 in a fully adjusted model. The graft failure rate gradually increased with ALP level increments of 20 IU/L in KTRs with ALP levels >60 IU/L. An increase in serum ALP level by 40 IU/L during the first 3 months after kidney transplant was associated with higher rates of graft failure (HR, 2.353) and higher rates of mortality (HR, 2.733).
Elevated pre-and posttransplant serum ALP levels and increases in the serum ALP levels after kidney transplant increase the risk of graft failure and mortality among KTRs.
近期研究表明，接受血液透析的患者血清碱性磷酸酶（ALP）水平升高与全因死亡和心血管死亡相关。然而，关于ALP水平对肾移植受者（KTRs）的影响，目前了解有限。本研究旨在评估移植前后血清ALP水平以及ALP水平的变化是否与移植肾失功和死亡率相关。
1997年1月至2012年12月期间，3029例KTRs纳入一个多中心队列研究。我们研究了KTRs移植前后血清ALP水平与长期预后的关系。
在完全校正模型中，移植前血清ALP水平>80 IU/L与移植肾失功的风险比（HR）为1.571相关。在ALP水平>60 IU/L的KTRs中，移植肾失功率随ALP水平每增加20 IU/L而逐渐升高。肾移植后前3个月血清ALP水平升高40 IU/L与移植肾失功率升高（HR，2.353）和死亡率升高（HR，2.733）相关。
移植前后血清ALP水平升高以及肾移植后血清ALP水平升高会增加KTRs移植肾失功和死亡的风险。
