Non-Renal Risk Factors for Chronic Kidney Disease in Liver Recipients with Functionally Intact Kidneys at 1 Monthopen access
- Kim, Deok-Gie; Hwang, Shin; Kim, Jong Man; Ryu, Je Ho; You, Young Kyoung; Choi, Donglak; Kim, Bong-Wan; Kim, Dong-Sik; Nah, Yang Won; Kim, Tae-Seok; Cho, Jai Young; Hong, Geun; Yang, Jae Do; Han, Jaryung; Suh, Suk-Won; Kim, Kwan Woo; Jung, Yun Kyung; Moon, Ju Ik; Lee, Jun Young; Kim, Sung Hwa; Lee, Jae Geun; Kim, Myoung Soo; Lee, Kwang-Woong; Joo, Dong Jin; Korean Organ Transplantation Registry Study Group; Yu, Young Dong(KOTRY Study Group); Jo, Hye-Sung(KOTRY Study Group); Park, PyoungJae(KOTRY Study Group); Kim, Wan-Joon(KOTRY Study Group)
- Issue Date
- MDPI AG
- liver transplantation; chronic kidney disease; renal dysfunction
- Journal of Clinical Medicine, v.11, no.14
- Journal Title
- Journal of Clinical Medicine
- Chronic kidney disease (CKD) is a critical complication of liver transplants, of which non-renal risk factors are not fully understood yet. This study aimed to reveal pre- and post-transplant risk factors for CKD (<60 mL/min/1.73 m(2)), examining liver recipients with functionally intact kidneys one month after grafting using nationwide cohort data. Baseline risk factors were analyzed with multivariable Cox regression analyses and post-transplant risk factors were investigated with the time-dependent Cox model and matched analyses of time-conditional propensity scores. Of the 2274 recipients with a one-month eGFR >= 60 mL/min/1.73 m(2), 494 (22.3%) developed CKD during a mean follow-up of 36.6 +/- 14.4 months. Age, female sex, lower body mass index, pre-transplant diabetes mellitus, and lower performance status emerged as baseline risk factors for CKD. Time-dependent Cox analyses revealed that recurrent hepatocellular carcinoma (HR = 1.93, 95% CI 1.06-3.53) and infection (HR = 1.44, 95% CI 1.12-1.60) were significant post-transplant risk factors for CKD. Patients who experienced one of those factors showed a significantly higher risk of subsequent CKD compared with the matched controls who lacked these features (p = 0.013 for recurrent hepatocellular carcinoma, and p = 0.003 for infection, respectively). This study clarifies pre- and post-transplant non-renal risk factors, which lead to renal impairment after LT independently from patients' renal functional reserve.
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- 2. Clinical Science > Department of Transplantation and Vascular Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
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