Source: Chest  |  Posted 4 years ago

By Jill Stein

BARCELONA, SPAIN -- April 13, 2007 -- Chronic renal dysfunction is an important complication after liver transplantation, and more than a fourth of patients satisfy criteria for chronic kidney disease (CKD) at 5 years, according to research presented here at the 42[^]nd[] Annual Meeting of the European Association for the Study of the Liver (EASL).

Peter Hayes, MD, professor, division of hepatology, Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Scotland, and associates, reviewed the records of 135 patients who received 148 elective liver transplants at their institution during a recent 4-year period.

"Few studies have focused on the prevalence of chronic kidney disease after liver transplantation," Dr. Hayes said on April 13[^]th[]. "What's more, little information is available on the rate of decline in renal function, which is important in the prediction of future chronic kidney disease and the need for dialysis."

Overall, 106 patients were alive 5 years post-transplant.

The prevalence of CKD increased progressively during the first 6 months post-transplant and thereafter showed no change.

At 5 years post-transplant, 28% of patients had CKD, 3% had severe CKD, and 1% had renal failure.

The cumulative rate of renal failure necessitating haemodialysis was 1.5% by 5 years.

Mean glomerular filtration rate (GFR) at 5 years was 31 mL/min/1.73m[^]2[], which was less than the preoperative value ([]P[] < .01).

Nearly half (46%) of patients showed deterioration of renal function that was faster than the rate expected with age, with a mean rate of decline of 4.5 mL/min/1.73 m[^]2[] per year.

By 5 years post-transplant, these patients had a lower GFR ([]P[] = .03), higher serum creatinine ([]P[] = .03), and a trend towards a greater prevalence of CKD compared with those who did not demonstrate such a decline ([]P[] = .07).

Dr. Hayes said that additional studies are needed to identify modifiable risk factors for both the development of CKD and decline in renal function.

[Presentation title: Chronic Renal Failure Post Liver Transplant: Prevalence and Rate of Decline. Abstract 164]