Low estimated glomerular filtration rate and chronic kidney failure following liver transplant: A retrospective cohort study

• Autor(a) principal: Narciso, Roberto Camargo [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Ferraz, Leonardo Rolim, Rodrigues, Cassio Jose de Oliveira [UNIFESP], Monte, Julio Cesar Martins [UNIFESP], Mies, Sergio, Santos, Oscar Fernando Pavao dos [UNIFESP], Paes, Angela Tavares, Cendoroglo Neto, Miguel [UNIFESP], Jaber, Bertrand L., Durao, Marcelino de Souza [UNIFESP], Batista, Marcelo Costa [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/36464; http://dx.doi.org/10.5301/ijao.5000201
• topic: Liver transplant; End-stage renal disease

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 preoperative 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 preoperative 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.