Evidence map›Paper›PMID 36564033›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2023

Dietary lithium intake, graft failure and mortality in kidney transplant recipients.

Adrian Post, Daan Kremer, Dion Groothof, Ulrike Seidel, Patricia Huebbe, Casper F M Franssen, Ido P Kema, Kai Lüersen, Gerald Rimbach, Stephan J L Bakker

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02811835 (Renal Sensing of the Acidifying Effect of Sulphur-containing Amino Acids), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02811835 active not recruitingnot on this map

Renal Sensing of the Acidifying Effect of Sulphur-containing Amino Acids: Consequences for the Relation Between Protein Intake and Blood Pressure in Renal Transplant Recipients

Typeobservational_patient_registrySponsorUniversity Medical Center GroningenRan2008 to 2028Enrolled1,007ConditionsTransplantation Infection, Renal Transplant Donor of Left Kidney
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
  3. Lithium: how low can you go?International journal of bipolar disorders · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 3 countries.

Adrian PostDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID 0000-0001-8645-1627
Daan KremerDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID 0000-0003-0011-115X
Dion GroothofDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID 0000-0002-1886-4451
Ulrike SeidelInstitute of Human Nutrition and Food Science, University of Kiel, Kiel, Germany.
Patricia HuebbeInstitute of Human Nutrition and Food Science, University of Kiel, Kiel, Germany.
Casper F M FranssenDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ido P KemaDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Kai LüersenInstitute of Human Nutrition and Food Science, University of Kiel, Kiel, Germany.
Gerald RimbachInstitute of Human Nutrition and Food Science, University of Kiel, Kiel, Germany.
Stephan J L BakkerDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NLChristian-Albrechts-Universität zu Kiel · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-term high-dose lithium therapy in bipolar disorder is known to adversely affect kidney function. However, recent animal studies have revealed that low amounts of lithium are beneficial for the kidney when it is damaged by exposure to nephrotoxic compounds, inflammation or oxidative stress. This study aimed to investigate whether urinary lithium excretion, reflecting dietary lithium intake, is associated with adverse long-term kidney graft outcomes and patient survival.

methodsUrinary lithium concentration was measured using inductively coupled plasma mass spectrometry in 642 stable kidney transplant recipients (KTRs). Graft failure was defined as the start of dialysis or retransplantation and kidney function decline was defined as a doubling of serum creatinine.

resultsThe median urinary lithium excretion was 3.03 μmol/24 h [interquartile range (IQR) 2.31-4.01]. Urinary lithium excretion was associated with energy, plant protein and water intake. During a median follow-up of 5.3 years (IQR 4.5-6.0), 79 (12%) KTRs developed graft failure and 127 (20%) KTRs developed kidney function decline. Higher urinary lithium excretion was associated with a lower risk of graft failure {hazard ratio [HR] per doubling 0.54 [95% confidence interval (CI) 0.38-0.79]} and kidney function decline [HR per doubling 0.73 (95% CI 0.54-0.99)]. These associations remained independent of adjustment for potential confounders and in sensitivity analyses. There was a significant effect modification with the use of proliferation inhibitors (P = .05) and baseline estimated glomerular filtration rate (eGFR; P < .001), with higher urinary lithium excretion being more protective in KTRs not using proliferation inhibitors and in KTRs with lower baseline eGFR. Furthermore, higher urinary lithium excretion was associated with a reduced risk of all-cause mortality [HR 0.64 (95% CI 0.49-0.83); P = .001].

conclusionDietary lithium intake may be a potentially modifiable, yet rather overlooked, risk factor for adverse long-term kidney graft outcomes and patient survival.

trial registrationhttps://clinicaltrials.gov/ct2/show/NCT02811835.

Indexed as

Kidney TransplantationHumansKidneyLithiumRenal DialysisRisk FactorsTransplant RecipientsLithiumgraft failurekidney transplant recipientslithiummortality

Identifiers

PMID36564033
PMCPMC10387402
OpenAlexW4312112375

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.