Renal sulfate reabsorption in healthy individuals and renal transplant recipients

Adrian Post, Isidor Minović*, Else van den Berg, Manfred L. Eggersdorfer, Gerjan J. Navis, Johanna M. Geleijnse, Reinold O.B. Gans, Harry van Goor, Joachim Struck, Casper F.M. Franssen, Ido P. Kema, Stephan J.L. Bakker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)


Inorganic sulfate is essential for normal cellular function and its homeostasis is primarily regulated in the kidneys. However, little is known about renal sulfate handling in humans and particularly in populations with impaired kidney function such as renal transplant recipients (RTR). Hence, we aimed to assess sulfate reabsorption in kidney donors and RTR. Plasma and urinary sulfate were determined in 671 RTR and in 251 kidney donors. Tubular sulfate reabsorption (TSR) was defined as filtered load minus sulfate excretion and fractional sulfate reabsorption (FSR) was defined as 1-fractional excretion. Linear regression analyses were employed to explore associations of FSR with baseline parameters and to identify the determinants of FSR in RTR. Compared to kidney donors, RTR had significantly lower TSR (15.2 [11.2–19.5] vs. 20.3 [16.7–26.3] μmol/min), and lower FSR (0.56 [0.48–0.64] vs. 0.64 [0.57–0.69]) (all P < 0.001). Kidney donation reduced both TSR and FSR by circa 50% and 25% respectively (both P < 0.001). In RTR and donors, both TSR and FSR associated positively with renal function. In RTR, FSR was independently associated with urinary thiosulfate (β = −0.18; P = 0.002), growth hormone (β = 0.12; P = 0.007), the intakes of alcohol (β = −0.14; P = 0.002), methionine (β = −0.34; P < 0.001), cysteine (β = −0.41; P < 0.001), and vitamin D (β = −0.14; P = 0.009). In conclusion, TSR and FSR are lower in RTR compared to kidney donors and both associated with renal function. Additionally, FSR is determined by various dietary and metabolic factors. Future research should determine the mechanisms behind sulfate handling in humans and the prognostic value of renal sulfate reabsorption in RTR.

Original languageEnglish
Article numbere13670
JournalPhysiological Reports
Issue number8
Publication statusPublished - 1 Apr 2018


  • Kidney donation
  • renal sulfate handling
  • renal transplant recipients
  • sulfate reabsorption

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