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Association of Serum Activin Levels with Allograft Outcomes in Patients with Kidney Transplant: Results from the KNOW-KT

Authors
 Hui-Yun Jung  ;  Jung-Hwa Ryu  ;  Myung-Gyu Kim  ;  Kyu Ha Huh  ;  Kyo Won Lee  ;  Hee-Yeon Jung  ;  Kyung Pyo Kang  ;  Han Ro  ;  Seungyeup Han  ;  Jaeseok Yang 
Citation
 AMERICAN JOURNAL OF NEPHROLOGY, Vol.55(2) : 245-254, 2024-04 
Journal Title
AMERICAN JOURNAL OF NEPHROLOGY
ISSN
 0250-8095 
Issue Date
2024-04
MeSH
Activins ; Allografts ; Cohort Studies ; Graft Survival ; Humans ; Kidney Transplantation* / adverse effects ; Risk Factors ; Treatment Outcome
Keywords
Activin ; Allograft failure ; Biomarker ; Coronary artery calcification ; Kidney outcome ; Kidney transplantation
Abstract
Introduction: Serum activin A has been reported to contribute to vascular calcification and kidney fibrosis in chronic kidney disease. We aimed to investigate whether higher serum activin levels were associated with poor allograft outcomes in patients with kidney transplantation (KT).

Methods: A total of 860 KT patients from KNOW-KT (Korean Cohort Study for Outcome in Patients with Kidney Transplantation) were analyzed. We measured serum activin levels pre-KT and 1 year after KT. The primary outcome was the composite of a ≥50% decline in estimated glomerular filtration rate and graft failure. Multivariable cause-specific hazard model was used to analyze association of 1-year activin levels with the primary outcome. The secondary outcome was coronary artery calcification score (CACS) at 5 years after KT.

Results: During the median follow-up of 6.7 years, the primary outcome occurred in 109 (12.7%) patients. The serum activin levels at 1 year were significantly lower than those at pre-KT (488.2 ± 247.3 vs. 704.0 ± 349.6). When patients were grouped based on the median activin level at 1 year, the high-activin group had a 1.91-fold higher risk (95% CI, 1.25-2.91) for the primary outcome compared to the low-activin group. A one-standard deviation increase in activin levels as a continuous variable was associated with a 1.36-fold higher risk (95% CI, 1.16-1.60) for the primary outcome. Moreover, high activin levels were significantly associated with 1.56-fold higher CACS (95% CI, 1.12-2.18).

Conclusion: Post-transplant activin levels were independently associated with allograft functions as well as coronary artery calcification in KT patients.
Full Text
https://karger.com/ajn/article/55/2/245/894155/
DOI
10.1159/000536198
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Jaeseok(양재석)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199131
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