UNASSIGNED: Renal transplant recipients (RTR) have an increased cardiovascular risk profile. Low levels of circulating @entity25450 ( @entity369 ) are a novel risk factor for mortality and the progression of @entity731 . The kidney is known as a major source of @entity369 , suggesting that urinary excretion of @entity369 (UhArg) might be associated with mortality and graft failure in RTR. @entity369 was quantified by mass spectrometry in 24-h urine samples of 704 RTR (functioning graft >= 1  year) and 103 healthy subjects. UhArg determinants were identified with multivariable linear regression models. Associations of UhArg with all-cause mortality and graft failure were assessed using multivariable Cox regression analyses. UhArg excretion was significantly lower in RTR compared to healthy controls [1.62 (1.09-2.61) vs. 2.46 (1.65-4.06)    mol/24  h, P  <  0.001]. In multivariable linear regression models, body surface area, diastolic blood pressure, @entity470 , pre-emptive transplantation, serum albumin, @entity633 , urinary excretion of @entity1133 and @entity414 and use of @entity3446 were positively associated with UhArg, while donor age and serum @entity4613 were inversely associated (model R (2)  =  0.43). During follow-up for 3.1 (2.7-3.9) years, 83 (12  %) @entity1 died and 45 (7  %) developed graft failure. UhArg was inversely associated with all-cause mortality [hazard risk (HR) 0.52 (95  % CI 0.40-0.66), P  <  0.001] and graft failure [HR 0.58 (0.42-0.81), P  =  0.001]. These associations remained independent of potential confounders. High UhArg levels are associated with reduced all-cause mortality and graft failure in RTR. Kidney-derived @entity369 is likely to be of particular importance for proper maintenance of @entity65 .

High urinary XXXX excretion is associated with low rates of all-cause mortality and graft failure in renal transplant recipients.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity25450 :: ('CHEBI:27747', 'Chemical') :: ['homoarginine'] @entity1133 :: ('MESH:D014508', 'Chemical') :: ['urea'] @entity470 :: ('1956', 'Gene') :: ['eGFR'] @entity4613 :: ('D010710', 'Chemical') :: ['phosphate'] @entity633 :: ('MESH:D000419', 'Disease') :: ['albuminuria'] @entity3446 :: ('MESH:D020123', 'Chemical') :: ['sirolimus'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular and renal systems'] @entity731 :: ('MESH:D050197', 'Disease') :: ['atherosclerosis'] @entity369 :: ('CHEBI:29016', 'Chemical') :: ['hArg'] @entity414 :: ('MESH:D014527', 'Chemical') :: ['uric acid']
@entity25450 :: (CHEBI:27747,Chemical) :: ['homoarginine']
