Longitudinal analysis of post-transplant electrolyte disorders and their impact on graft survival

Abstract

Imbalances in electrolytes are common complications after kidney transplantation. However,
the long-term influence of their focus on graft outcomes is understudied. The goal of the current study
is to analyze the incidence, the course, and the prognostic significance of electrolyte disturbances on
graft survivorship. The cohort study followed renal transplant recipients for three years, during which time
sodium, potassium, magnesium, calcium, and other clinical correlates were routinely assessed. The clinical
thresholds were then used to classify participants with unbalanced electrolytes, and survival outcomes
were assessed using Kaplan-Meier curves and Cox proportional hazards models. Results from the study
showed high prevalence of hyponatremia, hyperkalemia, and hypomagnesemia, all of which significantly
correlated with graft impairment survivorship; hypocalcemia had weaker correlations. Individuals who
had recurrent disturbances in the level of electrolytes suffered from a decline in graft function much earlier
than those who had normal content. Multivariate analysis showed that graft loss could not be avoided
even when demographic and immunologic confounders were accounted for, which reaffirms the notion
that electrolyte imbalance is a predictor of loss. Hence, the study outcomes call for the standard practice
of actively monitoring electrolytes with the goal of taking timely corrective action to improve long-term
outcomes following transplantation. The study found that an active, corrective approach to treating
electrolyte disorders is essential for achieving optimal transplant outcomes in conservatively managed
grafts.