Occurrence of Chronic Renal Failure in Liver Transplantation: Monitoring of Pre- and Posttransplantation Renal Function

• Published in: Transplantation proceedings Vol. 44; no. 7; pp. 1956 - 1959
• Main Authors: Umbro, I, Tinti, F, Piselli, P, Fiacco, F, Giannelli, V, Di Natale, V, Zavatto, A, Merli, M, Rossi, M, Ginanni Corradini, S, Poli, L, Berloco, P.B, Mitterhofer, A.P
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-09-2012; Elsevier
• Subjects: Biological and medical sciences; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - surgery; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Monitoring, Physiologic; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Renal failure; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue, organ and graft immunology; Kidney disease; Urinary system disease; Renal function; Chronic renal failure; Digestive system; Liver; Homotransplantation; Medicine; Treatment; Surveillance; Surgery; Graft; Monitoring; Liver transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.06.012

Abstract The aim of our study was to evaluate the occurrence of middle and long-term chronic renal failure (CRF) after orthotopic liver transplantation (OLT) in relation to acute renal failure (ARF). We prospectively monitored 75 patients, studying renal function on the basis of serum creatinine and glomerular filtration rate as estimated using the Modification of Diet in Renal Disease formula before as well as 1,6, and 12 months after OLT. The prevalence of ARF was 56% classified by the Acute Kidney injury Network criteria (52% stage 1, 29% stage 2, and 19% stage 3). The occurrences of CRF were 18.6% (11/59), 11.5% (6/52), and 14% (6/43) at 1, 6, and 12 months after OLT, respectively. The occurrence of CRF before OLT was 14.7%. We did not find any association between ARF and post-OLT CRF. The most relevant result of our study was the association between CRF at 6 and 12 months after transplantation with pre-OLT CRF on univariate and multivariate analysis. We suggest that evaluation of pre-OLT renal function should always be considered in the follow-up of liver transplant patients. Pre-OLT renal dysfunction must be recognized to be a risk factor for post-OLT CRF, representing important criterion to define specific therapeutic interventions to reduce patient morbidity and mortality.