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

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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

References

  1. Karapanagiotou A, Kydona C, Dimitriadis C, Sgourou K, Giasnetsova T, Fouzas I, et al. Acute kidney injury after orthotopic liver transplantation. Transplant Proc. 2012;44(9):2727–9. https://doi.org/10.1016/j.transproceed.2012.09.096.

    Article  CAS  PubMed  Google Scholar 

  2. Klaus F, Keitel da Silva C, Meinerz G, Carvalho LM, Goldani JC, Cantisani G, et al. Acute kidney injury after liver transplantation: incidence and mortality. Transplant Proc. 2014;46(6):1819–21. https://doi.org/10.1016/j.transproceed.2014.05.053.

    Article  CAS  PubMed  Google Scholar 

  3. Lewandowska L, Matuszkiewicz-Rowinska J. Acute kidney injury after procedures of orthotopic liver transplantation. Ann Transplant. 2011;16(2):103–8. https://doi.org/10.12659/aot.881872.

    Article  PubMed  Google Scholar 

  4. Narciso RC, Ferraz LR, Mies S, Monte JC, dos Santos OF, Neto MC, et al. Impact of acute kidney injury exposure period among liver transplantation patients. BMC Nephrol. 2013;14:43. https://doi.org/10.1186/1471-2369-14-43.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Zhu M, Li Y, Xia Q, Wang S, Qiu Y, Che M, et al. Strong impact of acute kidney injury on survival after liver transplantation. Transplant Proc. 2010;42(9):3634–8. https://doi.org/10.1016/j.transproceed.2010.08.059.

    Article  CAS  PubMed  Google Scholar 

  6. Cabezuelo JB, Ramirez P, Rios A, Acosta F, Torres D, Sansano T, et al. Risk factors of acute renal failure after liver transplantation. Kidney Int. 2006;69(6):1073–80. https://doi.org/10.1038/sj.ki.5000216.

    Article  CAS  PubMed  Google Scholar 

  7. Nuno J, Cuervas-Mons V, Vicente E, Turrion V, Pereira F, Mora NP, et al. Renal failure after liver transplantation: analysis of risk factors in 139 liver transplant recipients. Transpl Proc. 1995;27(4):2319–20.

    CAS  Google Scholar 

  8. Bilbao I, Charco R, Balsells J, Lazaro JL, Hidalgo E, Llopart L, et al. Risk factors for acute renal failure requiring dialysis after liver transplantation. Clin Transplant. 1998;12(2):123–9.

    CAS  PubMed  Google Scholar 

  9. Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349(10):931–40. https://doi.org/10.1056/NEJMoa021744.

    Article  CAS  PubMed  Google Scholar 

  10. Burra P, Senzolo M, Masier A, Prestele H, Jones R, Samuel D, et al. Factors influencing renal function after liver transplantation results from the MOST, an international observational study. Dig Liver Dis. 2009;41(5):350–6. https://doi.org/10.1016/j.dld.2008.09.018.

    Article  CAS  PubMed  Google Scholar 

  11. Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, et al. A model to predict survival in patients with end-stage liver disease. Hepatology (Baltimore, MD). 2001;33(2):464–70. https://doi.org/10.1053/jhep.2001.22172.

    Article  CAS  Google Scholar 

  12. Paramesh AS, Roayaie S, Doan Y, Schwartz ME, Emre S, Fishbein T, et al. Post-liver transplant acute renal failure: factors predicting development of end-stage renal disease. Clin Transplant. 2004;18(1):94–9.

    Article  Google Scholar 

  13. Gonwa TA, Jennings L, Mai ML, Stark PC, Levey AS, Klintmalm GB. Estimation of glomerular filtration rates before and after orthotopic liver transplantation: evaluation of current equations. Liver Transplant. 2004;10(2):301–9. https://doi.org/10.1002/lt.20017.

    Article  Google Scholar 

  14. Wong F, Nadim MK, Kellum JA, Salerno F, Bellomo R, Gerbes A, et al. Working Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis. Gut. 2011;60(5):702–9. https://doi.org/10.1136/gut.2010.236133.

    Article  PubMed  Google Scholar 

  15. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12. https://doi.org/10.7326/0003-4819-150-9-200905050-00006.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Velidedeoglu E, Bloom RD, Crawford MD, Desai NM, Campos L, Abt PL, et al. Early kidney dysfunction post liver transplantation predicts late chronic kidney disease. Transplantation. 2004;77(4):553–6. https://doi.org/10.1097/01.tp.0000114609.99558.41.

    Article  PubMed  Google Scholar 

  17. Kalisvaart M, Schlegel A, Trivedi PJ, Roberts K, Mirza DF, Perera T, et al. Chronic kidney disease after liver transplantation: impact of extended criteria grafts. Liver Transplant. 2019;25(6):922–33. https://doi.org/10.1002/lt.25468.

    Article  Google Scholar 

  18. Sharma P, Bari K. Chronic kidney disease and related long-term complications after liver transplantation. Adv Chronic kidney Dis. 2015;22(5):404–11. https://doi.org/10.1053/j.ackd.2015.06.001.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Trinh E, Alam A, Tchervenkov J, Cantarovich M. Impact of acute kidney injury following liver transplantation on long-term outcomes. Clin Transplant. 2017. https://doi.org/10.1111/ctr.12863.

    Article  PubMed  Google Scholar 

  20. Lee JP, Heo NJ, Joo KW, Yi NJ, Suh KS, Moon KC, et al. Risk factors for consequent kidney impairment and differential impact of liver transplantation on renal function. Nephrol Dial Transplant. 2010;25(8):2772–855. https://doi.org/10.1093/ndt/gfq093.

    Article  PubMed  Google Scholar 

  21. Trompeter R, Filler G, Webb NJ, Watson AR, Milford DV, Tyden G, et al. Randomized trial of tacrolimus versus cyclosporin microemulsion in renal transplantation. Pediatr Nephrol (Berlin, Germany). 2002;17(3):141–9. https://doi.org/10.1007/s00467-001-0795-9.

    Article  Google Scholar 

  22. Kendrick EA, McVicar JP, Kowdley KV, Bronner MP, Emond MJ, Alpers CE, et al. Renal disease in hepatitis C-positive liver transplant recipients. Transplantation. 1997;63(9):1287–93. https://doi.org/10.1097/00007890-199705150-00016.

    Article  CAS  PubMed  Google Scholar 

  23. Abrahamian GA, Cosimi AB, Farrell ML, Schoenfeld DA, Chung RT, Pascual M. Prevalence of hepatitis C virus-associated mixed cryoglobulinemia after liver transplantation. Liver Transplant. 2000;6(2):185–90. https://doi.org/10.1002/lt.500060224.

    Article  CAS  Google Scholar 

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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.

Authors and 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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  2. Yu- Jie Li
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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.

Ethics approval and consent to participate

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

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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

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