Renal Disease Burden Following Liver Transplantation

D. Y. Kim, C. Lim, R. Parasuraman, M. Raoufi, A. Yoshida, J. Arenas, J. Denny, L. Malinzak, M. Almarastani, D. Moonka, K. Brown, M. Sherbondy, S. Gordon, M. Abouljoud

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Abstract

Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT. Patients and Methods: We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras. Results: During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 ± 7 (mean ± standard deviation). The mean GFR at 6 months following OLT was 63.7 ± 30.2 mL/min per 1.73 m2. Only 14% (n = 47) of our patients had normal renal function at 6 months, while 78% (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs. Conclusions: The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.

Original languageEnglish (US)
Pages (from-to)3663-3665
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number10
DOIs
StatePublished - Dec 2006

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Liver Transplantation
Transplants
Kidney
Chronic Renal Insufficiency
Liver
Glomerular Filtration Rate
Diet Therapy
Living Donors
Disease Management
Renal Insufficiency
Allografts
Mortality
Population

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Kim, D. Y., Lim, C., Parasuraman, R., Raoufi, M., Yoshida, A., Arenas, J., ... Abouljoud, M. (2006). Renal Disease Burden Following Liver Transplantation. Transplantation Proceedings, 38(10), 3663-3665. https://doi.org/10.1016/j.transproceed.2006.10.054

Renal Disease Burden Following Liver Transplantation. / Kim, D. Y.; Lim, C.; Parasuraman, R.; Raoufi, M.; Yoshida, A.; Arenas, J.; Denny, J.; Malinzak, L.; Almarastani, M.; Moonka, D.; Brown, K.; Sherbondy, M.; Gordon, S.; Abouljoud, M.

In: Transplantation Proceedings, Vol. 38, No. 10, 12.2006, p. 3663-3665.

Research output: Contribution to journalArticle

Kim, DY, Lim, C, Parasuraman, R, Raoufi, M, Yoshida, A, Arenas, J, Denny, J, Malinzak, L, Almarastani, M, Moonka, D, Brown, K, Sherbondy, M, Gordon, S & Abouljoud, M 2006, 'Renal Disease Burden Following Liver Transplantation', Transplantation Proceedings, vol. 38, no. 10, pp. 3663-3665. https://doi.org/10.1016/j.transproceed.2006.10.054
Kim, D. Y. ; Lim, C. ; Parasuraman, R. ; Raoufi, M. ; Yoshida, A. ; Arenas, J. ; Denny, J. ; Malinzak, L. ; Almarastani, M. ; Moonka, D. ; Brown, K. ; Sherbondy, M. ; Gordon, S. ; Abouljoud, M. / Renal Disease Burden Following Liver Transplantation. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 10. pp. 3663-3665.
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abstract = "Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT. Patients and Methods: We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras. Results: During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 ± 7 (mean ± standard deviation). The mean GFR at 6 months following OLT was 63.7 ± 30.2 mL/min per 1.73 m2. Only 14{\%} (n = 47) of our patients had normal renal function at 6 months, while 78{\%} (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs. Conclusions: The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.",
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AU - Lim, C.

AU - Parasuraman, R.

AU - Raoufi, M.

AU - Yoshida, A.

AU - Arenas, J.

AU - Denny, J.

AU - Malinzak, L.

AU - Almarastani, M.

AU - Moonka, D.

AU - Brown, K.

AU - Sherbondy, M.

AU - Gordon, S.

AU - Abouljoud, M.

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N2 - Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT. Patients and Methods: We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras. Results: During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 ± 7 (mean ± standard deviation). The mean GFR at 6 months following OLT was 63.7 ± 30.2 mL/min per 1.73 m2. Only 14% (n = 47) of our patients had normal renal function at 6 months, while 78% (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs. Conclusions: The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.

AB - Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT. Patients and Methods: We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras. Results: During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 ± 7 (mean ± standard deviation). The mean GFR at 6 months following OLT was 63.7 ± 30.2 mL/min per 1.73 m2. Only 14% (n = 47) of our patients had normal renal function at 6 months, while 78% (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs. Conclusions: The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.

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