TY - JOUR
T1 - Renal function status in liver transplant patients in the first month post-transplant is associated with progressive chronic kidney disease
AU - Sato, Kazushige
AU - Kawagishi, Naoki
AU - Fujimori, Keisei
AU - Ohuchi, Noriaki
AU - Satomi, Susumu
N1 - Publisher Copyright:
© 2014 The Japan Society of Hepatology.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Renal dysfunction is a common complication of liver transplantation (LT), related to hepatorenal syndrome with end-stage liver disease or calcineurin-inhibitor nephrotoxicity. Chronic kidney disease (CKD) is also a common problem in long-term survivors post-LT. This study was done to investigate the association between renal functional status soon after LT and the development of CKD. Methods: We retrospectively evaluated 63 patients who were aged 18years or older, and underwent LT at Tohoku University Hospital. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease study equation for Japan. Results: Before transplantation, 25 patients (39.7%) were diagnosed with CKD (eGFR, <60mL/min per 1.73m2). The incidence of CKD was 22.4% (13/58) at 2years, 23.2% (13/56) at 3years and 22.7% (12/54) at 5years. The patients with CKD at 2years post-transplant were more likely to have a history of glomerulonephritis, and were significantly older at the time of LT, compared to those without CKD. Levels of eGFR of less than 60mL/min per 1.73m2 in the first month post-transplant and a volume of intraoperative blood loss of more than 300mL/kg were predictive factors for the development of CKD at 2years post-transplant and thereafter. Conclusion: We have shown that there is an improvement of renal function in the majority of patients after LT. Regardless of the presence of pre-existing CKD, both renal function status at the first month post-transplant and a volume of intraoperative blood loss were predictive factors for the development of CKD at 2years post-transplant and thereafter.
AB - Renal dysfunction is a common complication of liver transplantation (LT), related to hepatorenal syndrome with end-stage liver disease or calcineurin-inhibitor nephrotoxicity. Chronic kidney disease (CKD) is also a common problem in long-term survivors post-LT. This study was done to investigate the association between renal functional status soon after LT and the development of CKD. Methods: We retrospectively evaluated 63 patients who were aged 18years or older, and underwent LT at Tohoku University Hospital. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease study equation for Japan. Results: Before transplantation, 25 patients (39.7%) were diagnosed with CKD (eGFR, <60mL/min per 1.73m2). The incidence of CKD was 22.4% (13/58) at 2years, 23.2% (13/56) at 3years and 22.7% (12/54) at 5years. The patients with CKD at 2years post-transplant were more likely to have a history of glomerulonephritis, and were significantly older at the time of LT, compared to those without CKD. Levels of eGFR of less than 60mL/min per 1.73m2 in the first month post-transplant and a volume of intraoperative blood loss of more than 300mL/kg were predictive factors for the development of CKD at 2years post-transplant and thereafter. Conclusion: We have shown that there is an improvement of renal function in the majority of patients after LT. Regardless of the presence of pre-existing CKD, both renal function status at the first month post-transplant and a volume of intraoperative blood loss were predictive factors for the development of CKD at 2years post-transplant and thereafter.
KW - Calcineurin inhibitor
KW - Chronic kidney disease
KW - Estimated glomerular filtration rate
KW - Intraoperative blood loss
KW - Liver transplantation
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U2 - 10.1111/hepr.12339
DO - 10.1111/hepr.12339
M3 - Article
AN - SCOPUS:84921554083
VL - 45
SP - 220
EP - 227
JO - Hepatology Research
JF - Hepatology Research
SN - 1386-6346
IS - 2
ER -