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Non-Renal Risk Factors for Chronic Kidney Disease in Liver Recipients with Functionally Intact Kidneys at 1 Monthopen access

Authors
Kim, Deok-GieHwang, ShinKim, Jong ManRyu, Je HoYou, Young KyoungChoi, DonglakKim, Bong-WanKim, Dong-SikNah, Yang WonKim, Tae-SeokCho, Jai YoungHong, GeunYang, Jae DoHan, JaryungSuh, Suk-WonKim, Kwan WooJung, Yun KyungMoon, Ju IkLee, Jun YoungKim, Sung HwaLee, Jae GeunKim, Myoung SooLee, Kwang-WoongJoo, Dong JinKorean Organ Transplantation Registry Study GroupYu, Young Dong(KOTRY Study Group)Jo, Hye-Sung(KOTRY Study Group)Park, PyoungJae(KOTRY Study Group)Kim, Wan-Joon(KOTRY Study Group)
Issue Date
Jul-2022
Publisher
MDPI AG
Keywords
liver transplantation; chronic kidney disease; renal dysfunction
Citation
Journal of Clinical Medicine, v.11, no.14
Indexed
SCIE
SCOPUS
Journal Title
Journal of Clinical Medicine
Volume
11
Number
14
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61339
DOI
10.3390/jcm11144203
Abstract
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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Jo, Hye-Sung
Anam Hospital (Department of Hepato-Biliary-Pancreatic Surgery, Anam Hospital)
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