Association of pretransplant kidney function with outcomes after lung transplantation

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Abstract

Purpose: There is a lack of data regarding the independent association of pretransplant kidney function with early and late outcomes among lung transplant (LT) recipients. Methods: We queried the United Network for Organ Sharing database for adult patients (≥18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations. The study population was split into four groups (>90, 60-90, 45-59.9, and <45 mL/min/1.73 m2) based on the estimated GFR at the time of listing. Results: Overall, there was a good correlation between the GFR estimated from the two equations (n=17884, Pearson r=.816, P<.001). There was a consistent and independent association of worse early and late outcomes with declining GFR throughout the spectrum including those above 60 mL/min/1.73 m2 (P<.001 for overall comparisons). Although GFR<45 mL/min/1.73 m2 was associated with worse early and late survival, patients with GFR 45-59.9 mL/min/1.73 m2 do not appear to have survival advantage beyond 3 years post-transplant. Conclusion: There is a good correlation between GFR estimated using MDRD and CKD-EPI equations among patients being considered for LT. Early and late outcomes after LT worsen in a linear fashion with progressively lower pretransplant GFR.

Original languageEnglish (US)
Article numbere12932
JournalClinical Transplantation
Volume31
Issue number5
DOIs
StatePublished - May 1 2017

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Lung Transplantation
Glomerular Filtration Rate
Kidney
Transplants
Diet Therapy
Lung
Chronic Renal Insufficiency
Epidemiology
Survival
Databases

Keywords

  • chronic kidney disease
  • five-year survival
  • length of hospital stay
  • lung allocation score
  • one-year survival
  • prolonged hospitalization

ASJC Scopus subject areas

  • Transplantation

Cite this

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title = "Association of pretransplant kidney function with outcomes after lung transplantation",
abstract = "Purpose: There is a lack of data regarding the independent association of pretransplant kidney function with early and late outcomes among lung transplant (LT) recipients. Methods: We queried the United Network for Organ Sharing database for adult patients (≥18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations. The study population was split into four groups (>90, 60-90, 45-59.9, and <45 mL/min/1.73 m2) based on the estimated GFR at the time of listing. Results: Overall, there was a good correlation between the GFR estimated from the two equations (n=17884, Pearson r=.816, P<.001). There was a consistent and independent association of worse early and late outcomes with declining GFR throughout the spectrum including those above 60 mL/min/1.73 m2 (P<.001 for overall comparisons). Although GFR<45 mL/min/1.73 m2 was associated with worse early and late survival, patients with GFR 45-59.9 mL/min/1.73 m2 do not appear to have survival advantage beyond 3 years post-transplant. Conclusion: There is a good correlation between GFR estimated using MDRD and CKD-EPI equations among patients being considered for LT. Early and late outcomes after LT worsen in a linear fashion with progressively lower pretransplant GFR.",
keywords = "chronic kidney disease, five-year survival, length of hospital stay, lung allocation score, one-year survival, prolonged hospitalization",
author = "Amit Banga and Manish Mohanka and Jessica Mullins and Srinivas Bollineni and Vaidehi Kaza and Fernando Torres and Bekir Tanriover",
year = "2017",
month = "5",
day = "1",
doi = "10.1111/ctr.12932",
language = "English (US)",
volume = "31",
journal = "Clinical Transplantation",
issn = "0902-0063",
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TY - JOUR

T1 - Association of pretransplant kidney function with outcomes after lung transplantation

AU - Banga, Amit

AU - Mohanka, Manish

AU - Mullins, Jessica

AU - Bollineni, Srinivas

AU - Kaza, Vaidehi

AU - Torres, Fernando

AU - Tanriover, Bekir

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Purpose: There is a lack of data regarding the independent association of pretransplant kidney function with early and late outcomes among lung transplant (LT) recipients. Methods: We queried the United Network for Organ Sharing database for adult patients (≥18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations. The study population was split into four groups (>90, 60-90, 45-59.9, and <45 mL/min/1.73 m2) based on the estimated GFR at the time of listing. Results: Overall, there was a good correlation between the GFR estimated from the two equations (n=17884, Pearson r=.816, P<.001). There was a consistent and independent association of worse early and late outcomes with declining GFR throughout the spectrum including those above 60 mL/min/1.73 m2 (P<.001 for overall comparisons). Although GFR<45 mL/min/1.73 m2 was associated with worse early and late survival, patients with GFR 45-59.9 mL/min/1.73 m2 do not appear to have survival advantage beyond 3 years post-transplant. Conclusion: There is a good correlation between GFR estimated using MDRD and CKD-EPI equations among patients being considered for LT. Early and late outcomes after LT worsen in a linear fashion with progressively lower pretransplant GFR.

AB - Purpose: There is a lack of data regarding the independent association of pretransplant kidney function with early and late outcomes among lung transplant (LT) recipients. Methods: We queried the United Network for Organ Sharing database for adult patients (≥18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations. The study population was split into four groups (>90, 60-90, 45-59.9, and <45 mL/min/1.73 m2) based on the estimated GFR at the time of listing. Results: Overall, there was a good correlation between the GFR estimated from the two equations (n=17884, Pearson r=.816, P<.001). There was a consistent and independent association of worse early and late outcomes with declining GFR throughout the spectrum including those above 60 mL/min/1.73 m2 (P<.001 for overall comparisons). Although GFR<45 mL/min/1.73 m2 was associated with worse early and late survival, patients with GFR 45-59.9 mL/min/1.73 m2 do not appear to have survival advantage beyond 3 years post-transplant. Conclusion: There is a good correlation between GFR estimated using MDRD and CKD-EPI equations among patients being considered for LT. Early and late outcomes after LT worsen in a linear fashion with progressively lower pretransplant GFR.

KW - chronic kidney disease

KW - five-year survival

KW - length of hospital stay

KW - lung allocation score

KW - one-year survival

KW - prolonged hospitalization

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U2 - 10.1111/ctr.12932

DO - 10.1111/ctr.12932

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VL - 31

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SN - 0902-0063

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M1 - e12932

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