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Low Estimated Glomerular Filtration Rate and Chronic Kidney Failure following Liver Transplant: A Retrospective Cohort Study

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 transpl...

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Bibliographic Details
Published in:International journal of artificial organs 2013-07, Vol.36 (7), p.498-505
Main 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.
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Language:English
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Summary: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 m2 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.
ISSN:0391-3988
1724-6040
DOI:10.5301/ijao.5000201