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Boron Intake and decreased risk of mortality in kidney transplant recipients

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This prospective cohort analysis measured 24-hour urinary boron excretion by ICP-MS in 693 kidney transplant recipients and followed them for a median of 5.4 years. Fruit, wine and nuts were key dietary determinants of boron excretion. Higher boron excretion was associated with lower all-cause mortality, independent of age, sex, kidney function and cardiovascular history.

Key numbers

  • 24-hour urinary boron excretion: median 1275 µg/24 h (IQR 925 to 1729), n = 693 (Results, p. 3).
  • Deaths by tertile of boron excretion: 73 (32%), 47 (20%) and 30 (13%) in the lowest, middle and highest tertiles (Abstract).
  • Hazard ratio for mortality per doubling of boron excretion: 0.51 (95% CI 0.40 to 0.66), P < 0.001, adjusted for age, sex, eGFR and cardiovascular history (Abstract).
  • Median follow-up 5.4 years (4.8 to 6.1); 150 patients (22%) died (Results).
  • The discussion notes that a minimal safe mean population intake of 1 mg boron per day has been suggested by WHO and that many people consume less (Discussion, p. 10; cited, not measured).

Methods (brief)

TransplantLines Food and Nutrition Biobank and Cohort Study participants (enrolled 2008 to 2011) collected 24-hour urine; boron was measured by ICP-MS. Diet was assessed with a validated 177-item semi-quantitative food frequency questionnaire. Linear regression identified determinants of excretion; Cox regression assessed mortality and graft failure.

Evidence fitness

Supports urinary boron as an exposure marker in a clinical population and identifies plant foods and wine as determinants. The mortality association is observational and does not support causal benefit claims or intake thresholds.

Limitations

A single clinical population with a predominantly Dutch diet; urinary excretion may also reflect kidney function and dietary pattern. The cohort was supported by Top Institute Food and Nutrition (grant A-1003); authors declared no conflicts.

Update history

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