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Incidence of chronic kidney disease after orthotopic liver transplantation in a Chinese cohort

Clinical and Experimental Nephrology volume 24, pages 806–812 (2020)Cite this article

Abstract

Background

Kidney dysfunction frequently occurred after orthotopic liver transplantation (OLT). Chronic renal disease (CKD) is a complicated problem and is associated with increased mortality. The aim of this study is to find the risk factors for the incidence of CKD at 1 year after OLT in China.

Methods

From January 2017 to December 2017, we retrospectively assessed 280 recipients in our single center. Chronic renal failure was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months, regardless of the presence or absence of structural kidney damage. Cox proportional hazard model was used to identify the factors to the incidence of CKD after liver transplantations. Kaplan–Meier plots with log-rank test were presented to evaluate patient survival time in those with and without CKD.

Results

With a median follow-up of 17.4 months, 48 patients developed CKD after liver transplantations, representing 17.1% of the cohort. The cox-regression model showed that recipients age (HR = 1.097, P < 0.01), AKI (HR = 1.542, P < 0.01) and MELD score (HR = 1.077, P < 0.01) were significantly associated with the development of post-transplant CKD at 1 year. Recipient survival at 1 year was significantly worse in recipients with CKD compared to those without CKD (P < 0.01) after adjustment by age and gender.

Conclusion

Our findings suggested that age, AKI and MELD score were associated with the incidence of CKD 1 year after OLT in a Chinese cohort. Recipients with CKD were associated with worse survival.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AKI:

Acute kidney injury

CKD:

Chronic kidney disease

CNI:

Calcineurin inhibitor

DM:

Diabetes mellitus

eGFR:

Estimated glomerular filtration rate

HCV:

Hepatitis C virus

KDIGO:

Kidney Disease of Improving Global Outcomes

MELD:

Model of end-stage liver disease

OLT:

Orthotopic liver transplantation

RRT:

Renal replacement therapy

Scr:

Serum creatinine

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Funding

This work was supported by the grants from Science and Technology committee of Shanghai Municipality (No. 15411950400).

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Author notes

  1. Jiang-Chen Peng and Yu-Jie Li have contributed equally to this manuscript.

Affiliations

  1. Department of Critical Care, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China

    Jiang-Chen Peng, Yu- Jie Li, Jie -Min Wang, Ming-Li Zhu & Yuan Gao

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  1. Jiang-Chen Peng
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Contributions

JCP wrote the manuscript; YJL collected and analyzed the data; JMW did the statistical work; MLZ designed the study; YG reviewed and revised the manuscript.

Corresponding authors

Correspondence to Ming-Li Zhu or Yuan Gao.

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Competing interests

None of the authors has any potential conflicts of interest related to this article to declare and the results of this report have been produced, analyzed, and interpreted without any outside participation.

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Ethics committee of Shanghai Ren Ji hospital affiliated to Shanghai Jiao Tong University (approved number [2018]019).

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Cite this article

Peng, JC., Li, Y.J., Wang, J.M. et al. Incidence of chronic kidney disease after orthotopic liver transplantation in a Chinese cohort. Clin Exp Nephrol 24, 806–812 (2020). https://doi.org/10.1007/s10157-020-01910-y

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  • DOI: https://doi.org/10.1007/s10157-020-01910-y

Keywords

  • Liver transplantation
  • Chronic kidney disease
  • Risk factor
  • Survival