Prevalence and progression of chronic kidney disease after liver transplanta prospective, real-life, observational, two-year multicenter study
- José Ignacio Herrero Santos 1
- Valentín Cuervas Mons 2
- Miguel Ángel Gómez Bravo 3
- Joan Fabregat Prous 4
- Alejandra Otero 5
- Itxarone Bilbao Aguirre 6
- Magdalena Salcedo Plaza 7
- M. Luisa González Diéguez 5
- José Ramón Fernández 8
- M. Trinidad Serrano Aulló 9
- Miguel Jiménez Pérez 9
- Juan Miguel Rodrigo López 10
- Isidoro Jesús Narváez Rodríguez 11
- Gloria Sánchez Antolín 12
- 1 Clínica Universidad de Navarra. Pamplona, Spain
- 2 Hospital Universitario Puerta de Hierro. Majadahonda, Madrid. Spain
- 3 Hospital Virgen del Rocío. Sevilla, Spain
- 4 Hospital Universitario de Bellvitge. Barcelona, Spain
- 5 Hospital Universitario Central de Asturias. Oviedo, Spain
- 6 Hospital Universitario A Coruña. A Coruña, Spain
- 7 Hospital Universitario Gregorio Marañón. Madrid, Spain
- 8 Hospital Cruces. Bilbao, Spain
- 9 Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain
- 10 Hospital Regional Universitario Carlos Haya. Málaga, Spain
- 11 Hospital Infanta Cristina. Badajoz, Spain
- 12 Hospital Universitario Río Hortega. Valladolid, Spain
ISSN: 2340-416, 1130-0108
Ano de publicación: 2018
Volume: 110
Número: 9
Páxinas: 538-543
Tipo: Artigo
Outras publicacións en: Revista Española de Enfermedades Digestivas
Resumo
Introduction: chronic kidney disease is a frequent complication after liver transplantation. The use of calcineurin inhibitors is one of the causes of this complication. Current immunsuppression regimens that reduce the use of calcineurin inhibitors may be associated with an improved preservation of renal function. Objective: the study aimed to assess the evolution of renal function after liver transplantation in the current routine clinical practice. Methods: an observational, prospective, multicenter study in adult liver transplant recipients was performed. Two hundred and thirty patients with a good renal function before transplantation were assessed six months post-transplantation (baseline) and every six months until month 30. Results: at baseline, 32% of the patients had a reduction in the glomerular filtration rate below < 60 ml/min/1.73 m2. The mean glomerular filtration rate increased from 72.3 to 75.6 ml/min/1.73 m2 at baseline and month 30 respectively (p < 0.01). The mean serum creatinine levels (mg/dl) decreased from 1.13 to 1.09 (p < 0.01). The percentage of patients with stage 3 chronic kidney disease decreased from 31.7% to 26.4%, whereas the percentage of patients with stage 4 remained unchanged (0.4% at baseline and 0.5% at month 30). No patients progressed to end-stage kidney disease that required dialysis or renal transplantation. Conclusion: in the routine clinical practice, a moderate deterioration of renal function is frequent after liver transplantation. However, advanced chronic kidney disease is infrequent in patients with a good pre-transplant renal function.