The Relationship Between Pre-Transplant Serum Phosphorus Before Kidney Transplantation with Early Graft Dysfunction

Pre-transplant serum phosphorus level is shown to be associated with some transplant outcomes in patients with chronic kidney disease. However, its association with Delayed graft function (DGF) has an aura of ambiguity. DGF means either the patient needs dialysis during the first week after transplantation or the creatinine level is ≥ 3. This study was aimed to assess the relationship between pre-transplant serum phosphorus levels with DGF.

A total of 306 patients, who had undergone kidney transplantation in the Montaserieh organ transplantation hospital in Mashhad, Iran, during 2016 to 2019; were enrolled in this study. Demographic data and clinical characteristics of patients including dialysis type and duration, donor type, medications, pre-transplant serum levels of calcium, phosphorus and DGF development were measured. Then, all patients were divided into five groups according to their serum phosphorus: P < 3.5, 3.5 ≤ P < 5.5, 5.5 ≤ P < 7.5, 7.5 ≤ P < 9.5, and P ≥ 9.5 mg/dL. The association with DGF was evaluated by statistical analysis.

Patients age ranged from 18.00 to 64.00 years old, with an average of 37.08 ± 10.9. About 55.6% of them were men, and 26.1% came up with DGF. Among patients with DGF, 36.25% were recipients with pre-transplant phosphorus level of 3.5 ≤ P < 5.5 and 50% of 5.5 ≤ P < 7.5.

Our study suggested that pre-transplant serum phosphorus might be associated with an increased risk of delayed graft function. Further studies are needed to assess, whether adjusting serum phosphorus level before kidney transplantation could reduce delayed graft function or not.