Low Estimated Glomerular Filtration Rate and Chronic Kidney Failure following Liver Transplant: A Retrospective Cohort Study. Issue 7 (July 2013)

• Record Type: Journal Article
• Authors: Narciso, Roberto C.; Ferraz, Leonardo R.; Rodrigues, Cassio J. O.; Monte, Júlio C. M.; Mies, Sérgio; dos Santos, Oscar F. P.; Paes, Ângela T.; Cendoroglo, Miguel; Jaber, Bertrand L.; Durão, Marcelino S.; Batista, Marcelo C.
• Is Part Of: International journal of artificial organs. Volume 36:Issue 7(2013)
• Page Start: 498
• Page End: 505
• Publication Date: 2013-07
• Subjects: Liver transplant -- End-stage renal disease; Artificial organs -- Periodicals; 617.956
• DOI: 10.5301/ijao.5000201
• Languages: English
• ISSNs: 0391-3988

Abstract

Background: Patients undergoing orthotropic liver transplant (LTx) often present with chronic kidney disease (CKD). Identification of patients who will progress to end-stage renal disease (ESRD) might allow not only the implementation of kidney protective measures but also simultaneous kidney transplant. Study Design: Retrospective cohort study in adults who underwent LTx at a single center. ESRD, death, and composite of ESRD or death were studied outcomes. Results: 331 patients, who underwent LTx, were followed up for 2.6 ± 1.4 years; 31 (10%) developed ESRD, 6 (2%) underwent kidney transplant after LTx and 25 (8%) remained on chronic hemodialysis. Patients with pre-operative eGFR lesser than 60 ml/min per 1.73 m 2 had a 4-fold increased risk of developing ESRD after adjustment for sex, diabetes mellitus, APACHE II score, use of nephrotoxic drugs, and severe liver graft failure (HR = 3.95, 95% CI 1.73, 9.01; p = 0.001). Other independent risk factors for ESRD were pre-operative diabetes mellitus and post-operative severe liver graft dysfunction. Conclusion: These findings emphasize low eGFR prior to LTx as a predictor for ESRD or death. The consideration for kidney after liver transplant as a treatment modality should be taken into account for those who develop chronic kidney failure after LTx.