Progressive chronic kidney disease after pediatric lung transplantation

S. Paul Hmiel, Anne M. Beck, Maria Theresa De La Morena, Stuart Sweet

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

The development of chronic kidney disease (CKD) was evaluated in a large cohort of pediatric lung transplant recipients. Retrospective chart review identified 125 patients undergoing first lung transplant at St. Louis Children's Hospital and surviving 1 year. Mean age at transplant was 10.3 ± 0.55 years, while mean time after transplant was 4.9 years. Serum creatinine nearly doubled from baseline 0.48 mg/dL ± 0.02 (n = 125) to 0.87 mg/dL ± 0.04 (n = 120) at 1 year, and tripled to 1.39 mg/dL ± 0.15 (n = 23) by 7 years after transplant. The glomerular filtration rate (GFR), as estimated by the Schwartz formula, decreased from baseline 163 ± 5.9 mL/min/1.73 m2 (n = 109) to 88 ± 2.5 (n = 104), reaching 69 ± 9.0 (n = 6) by 10 years (p < 0.01). Seven patients developed end-stage kidney disease, and by 5 years after transplant, 38% of patients reached GFR < 60 mL/min. Older age at transplant and primary diagnosis of cystic fibrosis (CF) were both associated with decreased renal survival by Kaplan-Meier (KM) analysis. In summary, pediatric lung transplant recipients experience significant loss of renal function over time, as observed in other solid organ transplant recipients, and is most dramatic in adolescents.

Original languageEnglish (US)
Pages (from-to)1739-1747
Number of pages9
JournalAmerican Journal of Transplantation
Volume5
Issue number7
DOIs
StatePublished - Jul 2005

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Lung Transplantation
Chronic Renal Insufficiency
Pediatrics
Transplants
Glomerular Filtration Rate
Lung
Kidney
Kaplan-Meier Estimate
Cystic Fibrosis
Chronic Kidney Failure
Creatinine
Serum
Transplant Recipients

Keywords

  • Calcineurin toxicity
  • Children
  • Glomerular filtration rate

ASJC Scopus subject areas

  • Immunology

Cite this

Progressive chronic kidney disease after pediatric lung transplantation. / Hmiel, S. Paul; Beck, Anne M.; De La Morena, Maria Theresa; Sweet, Stuart.

In: American Journal of Transplantation, Vol. 5, No. 7, 07.2005, p. 1739-1747.

Research output: Contribution to journalArticle

Hmiel, S. Paul ; Beck, Anne M. ; De La Morena, Maria Theresa ; Sweet, Stuart. / Progressive chronic kidney disease after pediatric lung transplantation. In: American Journal of Transplantation. 2005 ; Vol. 5, No. 7. pp. 1739-1747.
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