Non-Renal Risk Factors for Chronic Kidney Disease in Liver Recipients with Functionally Intact Kidneys at 1 Month
- 주제(키워드) liver transplantation , chronic kidney disease , renal dysfunction
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kim, Deok-Gie; Lee, Jae Geun; Kim, Myoung Soo; Joo, Dong Jin] Yonsei Univ, Coll Med, Dept Surg, Seoul 03722, South Korea; [Hwang, Shin] Univ Ulsan, Asan Med Ctr, Coll Med, Dept Surg, Seoul 05505, South Korea; [Kim, Jong Man] Sungkyunkwan Univ, Samsung Med Ctr, Sch Med, Dept Surg, Seoul 06351, South Korea; [Ryu, Je Ho] Pusan Natl Univ, Yangsan Hosp, Sch Med, Dept Surg, Busan 49241, South Korea; [You, Young Kyoung] Catholic Univ Korea, Coll Med, Dept Surg, Seoul 06591, South Korea; [Choi, Donglak] Catholic Univ Daegu, Dept Surg, Daegu 42472, South Korea; [Kim, Bong-Wan] Ajou Univ, Sch Med, Dept Liver Transplantat & Hepatobiliary Surg, Suwon 16499, South Korea; [Kim, Dong-Sik] Korea Univ, Coll Med, Dept Surg, Seoul 02841, South Korea; [Nah, Yang Won] Univ Ulsan, Ulsan Univ Hosp, Coll Med, Dept Surg, Ulsan 44033, South Korea; [Kim, Tae-Seok] Keimyung Univ, Sch Med, Dongsan Med Ctr, Dept Surg, Daegu 42601, South Korea; [Cho, Jai Young] Seoul Natl Univ, Bundang Hosp, Dept Surg, Seongnam 13620, South Korea; [Hong, Geun] EWHA Womans Univ, Coll Med, Dept Surg, Seoul 07804, South Korea; [Yang, Jae Do] Jeonbuk Natl Univ Hosp, Dept Surg, Jeonju 54896, South Korea; [Han, Jaryung] Kyungpook Natl Univ Hosp, Dept Surg, Daegu 41944, South Korea; [Suh, Suk-Won] Chung Ang Univ, Coll Med, Dept Surg, Seoul 06974, South Korea; [Kim, Kwan Woo] Dong A Univ Hosp, Dept Surg, Busan 49201, South Korea; [Jung, Yun Kyung] Hanyang Univ, Dept Surg, Seoul 04764, South Korea; [Moon, Ju Ik] Konyang Univ Hosp, Dept Surg, Daejeon 35365, South Korea; [Lee, Jun Young] Yonsei Univ, Wonju Coll Med, Dept Nephrol, Wonju 26426, South Korea; [Kim, Sung Hwa] Yonsei Univ, Wonju Coll Med, Dept Biostat, Wonju 26426, South Korea; [Lee, Kwang-Woong] Seoul Natl Univ, Coll Med, Dept Surg, Seoul 03087, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 MDPI
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000194608
- 본문언어 영어
- Published As https://doi.org/10.3390/jcm11144203
- PubMed https://pubmed.ncbi.nlm.nih.gov/35887972
초록/요약
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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