Effect of Acid-Base Balance on Cytokines Serum Levels and Short-Term Outcomes in Kidney Transplant Recipients; a Randomized Clinical Trial
Journal of Cellular & Molecular Anesthesia,
Vol. 3 No. 1 (2018),
31 January 2018
,
Page 3-13
https://doi.org/10.22037/jcma.v3i1.19537
Abstract
Background: Control of blood acids and bases can help prevent many potentially life-threatening disorders in end stage renal disease (ESRD) patients. Aim of this study was to assess the effect of acid-base balance on cytokines serum levels and short-term outcomes in kidney transplant recipients.
Materials and Methods: In this randomized clinical trial study, 40 patients with end-stage renal disease aged 18 to 70 who had undergone a kidney transplant from a living donor in Modarres hospital during 2016-2017 were included. The primary outcomes measured in this study were sera levels of cytokine such as IL-2, IL-10, IFN-γ and BUN and Cr serum after the treatment of acidosis in kidney transplant recipients.
Results: Mean±SD of the patient’s age was 42±12.6 years. Results showed that there is a significant difference in means of IL-2, IL-10, and IFN-γ between the intervention and control groups over the time (for all p<0.05). We also found that correction of acidosis occurred with reduces of IFN-γ to -1.74 in the intervention group compared to the group receiving saline (P=0.011); and reduction for IL-2 was -1.37 (p=0.025). The concentration of anti-inflammatory cytokine of IL-10 was increased to 2.85 (P<0.001).
Conclusion: The results clearly suggest that correction of acidosis in renal transplant patients during surgery helps improve the performance of allograft in the short run; however, more studies are recommended, taking into account the long-term and short-term effects of this intervention.
Keywords: Cytokines, Kidney Transplantation, Acid-Base Balance, Randomized Controlled Trial
- Cytokines
- Kidney Transplantation
- Acid-Base Balance
- Randomized Controlled Trial
How to Cite
References
Neuberger JM, Bechstein WO, Kuypers DR, Burra P, Citterio F, De Geest S, et al. Practical Recommendations for Long-term
anagement of Modifiable Risks in Kidney and Liver Transplant Recipients: A Guidance Report and Clinical Checklist by the Consensus on Managing Modifiable Risk in Transplantation (COMMIT) Group. Transplantation. 2017;101(4S Suppl 2):S1-S56.
Gondos A, Döhler B, Brenner H, Opelz G. Kidney graft survival in Europe and the United States: strikingly different long-term outcomes. Transplantation. 2013;95(2):267-74.
Spiro MD, Eilers H. Intraoperative care of the transplant patient. Anesthesiol Clin. 2013;31(4):705-21.
Witham MD, Lamb EJ. Should chronic metabolic acidosis be treated in older people with chronic kidney disease? Nephrol Dial Transplant. 2016;31(11):1796-1802.
Dobre M, Rahman M, Hostetter TH. Current status of bicarbonate in CKD. J Am Soc Nephrol. 2015;26(3):515-23.
Chen W, Bai J, Huang H, Bi L, Kong X, Gao Y, et al. Low proportion of follicular regulatory T cell in renal transplant patients with chronic antibody-mediated rejection. Sci Rep. 2017;7(1):1322.
Trojan K, Zhu L, Aly M, Weimer R, Bulut N, Morath C, et al. Association of peripheral NK cell counts with Helios+ IFN‐γ–Tregs in patients with good long‐term renal allograft function. Clin Exp Immunol. 2017;188(3):467-79.
Wang Y, McDermott S, Mann JR, Hardin JW. Preventing intellectual disability during pregnancy: what are the potentially high yield targets? J Perinat Med. 2016 1;44(4):421-32.
Karthikeyan V, Karpinski J, Nair RC, Knoll G. The burden of chronic kidney disease in renal transplant recipients. Am J Transplant. 2004;4(2):262-9.
Kukla A, Adulla M, Pascual J, Samaniego M, Nanovic L, Becker BN, et al. CKD stage-to-stage progression in native and transplant kidney disease. Nephrol Dial Transplant. 2008;23(2):693-700.
Gill JS, Tonelli M, Mix CH, Pereira BJ. The change in allograft function among long-term kidney transplant recipients. J Am Soc Nephrol. 2003;14(6):1636-42.
Massarweh NN, Clayton JL, Mangum CA, Florman SS, Slakey DP. High body mass index and short-and long-term renal allograft survival in adults. Transplantation. 2005;80(10):1430-4.
Park S, Kang E, Park S, Kim YC, Han SS, Ha J, et al. Metabolic Acidosis and Long-Term Clinical Outcomes in Kidney Transplant Recipients. J Am Soc Nephrol. 2017;28(6):1886-97.
Yakupoglu HY, Corsenca A, Wahl P, Wüthrich RP, Ambühl PM. Posttransplant acidosis and associated disorders of mineral metabolism in patients with a renal graft. Transplantation. 2007;84(9):1151-7.
Kellum JA, Song M, Li J. Science review: extracellular acidosis and the immune response: clinical and physiologic implications. Crit Care. 2004;8(5):331-6.
Keven K, Ozturk R, Sengul S, Kutlay S, Ergun I, Erturk S, et al. Renal tubular acidosis after kidney transplantation—incidence, risk factors and clinical implications. Nephrol Dial Transplant. 2007;22(3):906-10.
Chinen J, Buckley RH. Transplantation immunology: solid organ and bone marrow. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S324-35.
Katalinić L, Blaslov K, Đanić-Hadžibegović A, Gellineo L, Kes P, Jelaković B, et al. METABOLIC ACIDOSIS--AN UNDERESTIMATED PROBLEM AFTER KIDNEY TRANSPLANTATION? Acta Clin Croat. 2015;54(4):486-91.
Ori Y, Zingerman B, Bergman M, Bessler H, Salman H. The effect of sodium bicarbonate on cytokine secretion in CKD patients with metabolic acidosis. Biomed Pharmacother. 2015;71:98-101.
Shiu KY, McLaughlin L, Rebollo-Mesa I, Zhao J, Burton H, Douthwaite H, et al. Graft dysfunction in chronic antibody-mediated rejection correlates with B-cell–dependent indirect antidonor alloresponses and autocrine regulation of interferon-γ production by Th1 cells. Kidney Int. 2017; 91(2): 477–492..
Slavcev A, Rybakova K, Svobodova E, Slatinska J, Honsova E, Skibova J, Viklicky O, Striz I. Pre-transplant donor-specific Interferon-gamma-producing cells and acute rejection of the kidney allograft. Transpl Immunol. 2015;33(2):63-8..
Messa PG, Alfieri C, Vettoretti S. Metabolic acidosis in renal transplantation: neglected but of potential clinical relevance. Nephrol Dial Transplant. 2016;31(5):730-6.
- Abstract Viewed: 398 times
- PDF Downloaded: 211 times