{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:49:45Z","timestamp":1784893785525,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic acidosis is an independent risk factor for kidney disease progression with a high prevalence after kidney transplantation (KTx). Remarkably, it is still unclear if there is an impact of metabolic acidosis on graft function and death after KTx. Thus, we wanted to investigate if serum bicarbonate is associated with long-term graft outcome and mortality after KTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a single-center retrospective study including adult de novo KTx patients between 1999 and 2015. Cox proportional hazard model was used to analyze a possible association between time-dependent serum bicarbonate measurements and graft failure or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four hundred thirty KTRs were included in the analysis with a mean age of 50.9\u2009\u00b1\u200913.4\u00a0years. Mean observation time was 4.7\u2009\u00b1\u20092.8\u00a0years. Two hundred eighty-four (66%) patients were male and 318 (74%) had received a deceased donor kidney transplant. Mean bicarbonate and eGFR levels 1 year post-transplant amounted to 22.9\u2009\u00b1\u20093.1\u00a0mEq\/L and 61\u2009\u00b1\u200926\u00a0ml\/min\/1.73 m2, respectively. Prevalence of metabolic acidosis was 31% 1 year after transplantation. Fourteen (3%) patients died and 31 (7%) suffered from graft failure. Higher bicarbonate levels were associated with significantly lower hazards for graft failure (Hazard Ratio (HR)\u2009=\u20090.88; 95% Confidence Interval (CI): 0.79\u20130.98) and mortality (HR\u2009=\u20090.79; 95% CI 0.66\u20130.93) after adjusting for potential confounders such as age, donor type and time-varying eGFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our analysis showed that higher serum bicarbonate levels are positively associated with long-term graft and patient survival in kidney transplant recipients. Thus, serum bicarbonate may serve as a predictor and independent risk factor for graft and patient outcome after KTx as has been previously shown for patients with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-021-01197-6","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T04:02:31Z","timestamp":1638158551000},"page":"619-627","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association of serum bicarbonate with graft survival and mortality in kidney transplant recipients"],"prefix":"10.1093","volume":"35","author":[{"given":"Anna","family":"Wiegand","sequence":"first","affiliation":[{"name":"Division of Nephrology, University Hospital Z\u00fcrich,R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandar Felicity","family":"Lim","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute (EBPI),University of Z\u00fcrich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seraina","family":"von Moos","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital Z\u00fcrich,R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf Peter","family":"W\u00fcthrich","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital Z\u00fcrich,R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonhard","family":"Held","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute (EBPI),University of Z\u00fcrich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-9733","authenticated-orcid":false,"given":"Nilufar","family":"Mohebbi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital Z\u00fcrich,R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"issue":"3","key":"2026012108030320500_CR1","doi-asserted-by":"publisher","first-page":"345","DOI":"10.5527\/wjn.v4.i3.345","article-title":"Estimating glomerular filtration rate in kidney transplantation: Still searching for the best marker","volume":"4","author":"Santos","year":"2015","journal-title":"World J Nephrol"},{"issue":"Suppl 1","key":"2026012108030320500_CR2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1111\/ajt.12579","article-title":"OPTN\/SRTR 2012 Annual Data Report: 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March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors declare no conflicts of interest. We confirm that the results presented in this paper have not been published previously in whole or part, except in abstract form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}