Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 16;14(1):1413.
doi: 10.1038/s41598-024-51748-7.

Low urinary sodium-to-potassium ratio in the early phase following single-unit cord blood transplantation is a predictive factor for poor non-relapse mortality in adults

Kosuke Takano  1 , Maki Monna-Oiwa  1 , Masamichi Isobe  1 , Seiko Kato  2 , Satoshi Takahashi  2 , Yasuhito Nannya  1 , Takaaki Konuma  3
Affiliations

Low urinary sodium-to-potassium ratio in the early phase following single-unit cord blood transplantation is a predictive factor for poor non-relapse mortality in adults

Kosuke Takano et al. Sci Rep. .

Abstract

Although daily higher urinary sodium (Na) and potassium (K) excretion ratio is associated with the risk of cardiovascular disease in the general population, a low Na/K ratio is associated with renal dysfunction in critically ill patients. Thus, we retrospectively analyzed the impact of daily urinary Na and K excretion and their ratio on non-relapse mortality (NRM) and overall mortality in 172 adult single-unit cord blood transplantation (CBT) patients treated at our institution between 2007 and 2020. Multivariate analysis showed that a low urinary Na/K ratio at both 14 days (hazard ratio [HR], 4.82; 95% confidence interval [CI], 1.81-12.83; P = 0.001) and 28 days (HR, 4.47; 95% CI 1.32-15.12; P = 0.015) was significantly associated with higher NRM. Furthermore, a low urinary Na/K ratio at 28 days was significantly associated with higher overall mortality (HR, 2.38; 95% CI 1.15-4.91; P = 0.018). Patients with a low urinary Na/K ratio had decreased urine volume, more weight gain, experienced more grade III-IV acute graft-versus-host disease, and required corticosteroids by 28 days after CBT. These findings indicate that a low urinary Na/K ratio early after single-unit CBT is associated with poor NRM and survival in adults.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Correlation between daily urinary Na/K ratio and daily urinary Na excretion (a, e), daily urinary K excretion (b, f), simultaneous calculated creatinine clearance (CrCl) (c, g), and fractional excretion of sodium (FENa) (d, h) at 14 and 28 days post-CBT.
Figure 2
Figure 2
Correlation between CSP trough levels and daily urinary Na excretion (a, f), daily urinary K excretion (b, g), daily urinary Na/K ratio (c, h), simultaneous calculated creatinine clearance (CrCl) (d, i), and fractional excretion of sodium (FENa) (e, j) at 14 and 28 days post-CBT.
Figure 3
Figure 3
The effect of daily urinary Na/K ratio on non-relapse mortality (NRM) and overall survival (OS) following CBT. The cumulative incidence curves for NRM and Kaplan–Meier survival curves for OS based on daily urinary Na/K ratio were plotted, with a conditional landmark analysis conducted at both 14 (a, c) and 28 days (b, d) post-CBT. Three patients died or developed anuria before the evaluation of daily urinary Na and K excretion at day 28. In addition, one patient experienced relapse at 28 days.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Takahashi S, et al. Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies. Blood. 2004;104:3813–3820. doi: 10.1182/blood-2004-03-1001. - DOI - PubMed
    1. Takahashi S, et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood. 2007;109:1322–1330. doi: 10.1182/blood-2006-04-020172. - DOI - PubMed
    1. Shouval R, et al. Outcomes of allogeneic haematopoietic stem cell transplantation from HLA-matched and alternative donors: A European Society for Blood and Marrow Transplantation registry retrospective analysis. Lancet Haematol. 2019;6:e573–e584. doi: 10.1016/S2352-3026(19)30158-9. - DOI - PubMed
    1. Miyao K, et al. Updated comparison of 7/8 HLA allele-matched unrelated bone marrow transplantation and single-unit umbilical cord blood transplantation as alternative donors in adults with acute leukemia. Biol. Blood Marrow Transplant. 2020;26:2105–2114. doi: 10.1016/j.bbmt.2020.08.001. - DOI - PubMed
    1. Konuma T, et al. Single cord blood transplantation versus unmanipulated haploidentical transplantation for adults with acute myeloid leukemia in complete remission. Transplant. Cell. Ther. 2021;27(334):e1–334.e11. - PubMed