Incidence of chronic kidney disease after orthotopic liver transplantation in a Chinese cohort

Clin Exp Nephrol. 2020 Sep;24(9):806-812. doi: 10.1007/s10157-020-01910-y. Epub 2020 Jun 5.

Abstract

Background: Kidney dysfunction frequently occurred after orthotopic liver transplantation (OLT). Chronic renal disease (CKD) is a complicated problem and is associated with increased mortality. The aim of this study is to find the risk factors for the incidence of CKD at 1 year after OLT in China.

Methods: From January 2017 to December 2017, we retrospectively assessed 280 recipients in our single center. Chronic renal failure was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months, regardless of the presence or absence of structural kidney damage. Cox proportional hazard model was used to identify the factors to the incidence of CKD after liver transplantations. Kaplan-Meier plots with log-rank test were presented to evaluate patient survival time in those with and without CKD.

Results: With a median follow-up of 17.4 months, 48 patients developed CKD after liver transplantations, representing 17.1% of the cohort. The cox-regression model showed that recipients age (HR = 1.097, P < 0.01), AKI (HR = 1.542, P < 0.01) and MELD score (HR = 1.077, P < 0.01) were significantly associated with the development of post-transplant CKD at 1 year. Recipient survival at 1 year was significantly worse in recipients with CKD compared to those without CKD (P < 0.01) after adjustment by age and gender.

Conclusion: Our findings suggested that age, AKI and MELD score were associated with the incidence of CKD 1 year after OLT in a Chinese cohort. Recipients with CKD were associated with worse survival.

Keywords: Chronic kidney disease; Liver transplantation; Risk factor; Survival.

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Adult
  • Age Factors
  • End Stage Liver Disease / surgery*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate