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Chronic kidney disease following liver transplantation: a South Australian experience.
Transplant Proc. 2010 Nov; 42(9):3644-6.TP

Abstract

The incidence of chronic kidney disease (CKD) and its impact on survival have not been widely studied in the Australian liver transplant (OLT) population. The aims of this study were to evaluate the prevalence of CKD stages at various time points, calculate the cumulative incidence of progression to severe CKD, and study the impact of CKD stages on patient survival and risk factors for severe CKD in a single-center post-OLT population. We studied retrospectively 130 patients who underwent OLT in South Australia with a minimum of 6 months of follow-up from 1992 to 2008. CKD was staged according to Kidney Diseases Outcome Quality Initiative Guidelines. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation. Multiple pre- and post-OLT variables were examined for their association with severe CKD. Log-rank tests and Cox regression analysis were performed to evaluate the survival data. The cumulative incidences of severe CKD (stages 4 and 5) at 2, 5, and 15 years were 3.8%, 12.7%, and 14.8%, respectively. Severe CKD was associated with an increased mortality (hazard ratio 6.5; 95% confidence interval = 2.5-17.0; P < .001). Mild and moderate CKD stages were not associated with increased mortality. Risk factors for severe CKD were: female gender, hepatitis C infection, pre-OLT diabetes, acute renal failure post-OLT, and low 1-year GFR. Mild and moderate CKD are common post-OLT. The development of severe CKD, which can be predicted early in the post-OLT period, is strongly associated with an increased mortality rate.

Authors+Show Affiliations

South Australian Liver Transplant Unit, Flinders Medical Centre, Adelaide, Australia. jeyapati@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21094832

Citation

Ramachandran, J, et al. "Chronic Kidney Disease Following Liver Transplantation: a South Australian Experience." Transplantation Proceedings, vol. 42, no. 9, 2010, pp. 3644-6.
Ramachandran J, Juneja R, John L, et al. Chronic kidney disease following liver transplantation: a South Australian experience. Transplant Proc. 2010;42(9):3644-6.
Ramachandran, J., Juneja, R., John, L., Dutta, A. K., Chen, J. W., Woodman, R. J., & Wigg, A. J. (2010). Chronic kidney disease following liver transplantation: a South Australian experience. Transplantation Proceedings, 42(9), 3644-6. https://doi.org/10.1016/j.transproceed.2010.06.022
Ramachandran J, et al. Chronic Kidney Disease Following Liver Transplantation: a South Australian Experience. Transplant Proc. 2010;42(9):3644-6. PubMed PMID: 21094832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic kidney disease following liver transplantation: a South Australian experience. AU - Ramachandran,J, AU - Juneja,R, AU - John,L, AU - Dutta,A K, AU - Chen,J W, AU - Woodman,R J, AU - Wigg,A J, PY - 2010/02/10/received PY - 2010/06/18/accepted PY - 2010/11/25/entrez PY - 2010/11/26/pubmed PY - 2011/3/8/medline SP - 3644 EP - 6 JF - Transplantation proceedings JO - Transplant Proc VL - 42 IS - 9 N2 - The incidence of chronic kidney disease (CKD) and its impact on survival have not been widely studied in the Australian liver transplant (OLT) population. The aims of this study were to evaluate the prevalence of CKD stages at various time points, calculate the cumulative incidence of progression to severe CKD, and study the impact of CKD stages on patient survival and risk factors for severe CKD in a single-center post-OLT population. We studied retrospectively 130 patients who underwent OLT in South Australia with a minimum of 6 months of follow-up from 1992 to 2008. CKD was staged according to Kidney Diseases Outcome Quality Initiative Guidelines. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation. Multiple pre- and post-OLT variables were examined for their association with severe CKD. Log-rank tests and Cox regression analysis were performed to evaluate the survival data. The cumulative incidences of severe CKD (stages 4 and 5) at 2, 5, and 15 years were 3.8%, 12.7%, and 14.8%, respectively. Severe CKD was associated with an increased mortality (hazard ratio 6.5; 95% confidence interval = 2.5-17.0; P < .001). Mild and moderate CKD stages were not associated with increased mortality. Risk factors for severe CKD were: female gender, hepatitis C infection, pre-OLT diabetes, acute renal failure post-OLT, and low 1-year GFR. Mild and moderate CKD are common post-OLT. The development of severe CKD, which can be predicted early in the post-OLT period, is strongly associated with an increased mortality rate. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/21094832/Chronic_kidney_disease_following_liver_transplantation:_a_South_Australian_experience_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(10)01286-8 DB - PRIME DP - Unbound Medicine ER -