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Chronic kidney disease after heart transplantation: a single-centre retrospective study at skåne university hospital in lund 1988-2010.

Söderlund, Carl LU ; Löfdahl, Eveline; Nilsson, Johan LU ; Reitan, Öyvind LU ; Higgins, Thomas and Rådegran, Göran LU (2016) In Transplant international : official journal of the European Society for Organ Transplantation 29(5). p.529-539
Abstract
We aimed to study the incidence, predictors, and outcome of chronic kidney disease (CKD) after heart transplantation (HT). All our HT patients 1988-2010 were considered for inclusion. Of these, 134 came for annual follow-ups including evaluation of glomerular filtration rate (GFR) using iohexol clearance measurements, and the CKD-EPI (adults) or Schwartz (children) formulae. Median GFR (Q1-Q3)(mL/min/1.73m(2) ) declined from 67.0 (50.0-82.0) during transplant assessment (TA), to 56.0 (45.0-69.0) at year 1, 53.0 (41.0-68.0) at year 5 and 44.5 (25.0-57.3) at year 10. The cumulative incidence of CKD ≥ stage 4 was 25% at 5 years and 41% at 10 years after transplantation. Proteinuria the first year post-HT was the only predictor related... (More)
We aimed to study the incidence, predictors, and outcome of chronic kidney disease (CKD) after heart transplantation (HT). All our HT patients 1988-2010 were considered for inclusion. Of these, 134 came for annual follow-ups including evaluation of glomerular filtration rate (GFR) using iohexol clearance measurements, and the CKD-EPI (adults) or Schwartz (children) formulae. Median GFR (Q1-Q3)(mL/min/1.73m(2) ) declined from 67.0 (50.0-82.0) during transplant assessment (TA), to 56.0 (45.0-69.0) at year 1, 53.0 (41.0-68.0) at year 5 and 44.5 (25.0-57.3) at year 10. The cumulative incidence of CKD ≥ stage 4 was 25% at 5 years and 41% at 10 years after transplantation. Proteinuria the first year post-HT was the only predictor related (p<0.05) to a higher rate of GFR decline (HR 5.15, 95% CI 1.23-21.55). GFR ≥60 as compared to <60 before HT, or a first year GFR decline <30% as compared to >30%, was moreover associated (p<0.05) with a lower risk of death (HR 0.30, 95% CI 0.12-0.76 and HR 0.35, 95% CI 0.13-0.90, respectively). Notably, the CKD-EPI and Schwartz formulae overestimated GFR by 28±29% and 26±33%, respectively. In conclusion, CKD in HT patients is common and associated with worse outcome. To avoid diagnostic delay, GFR estimating equation's validity in HT patients needs further study. This article is protected by copyright. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Transplant international : official journal of the European Society for Organ Transplantation
volume
29
issue
5
pages
529 - 539
publisher
Springer
external identifiers
  • PMID:26531026
  • Scopus:84964576017
ISSN
1432-2277
DOI
10.1111/tri.12710
language
English
LU publication?
yes
id
49feacd4-0d47-402a-a39e-13b04e68c21a (old id 8243378)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26531026?dopt=Abstract
date added to LUP
2015-12-02 18:54:34
date last changed
2016-10-13 04:31:09
@misc{49feacd4-0d47-402a-a39e-13b04e68c21a,
  abstract     = {We aimed to study the incidence, predictors, and outcome of chronic kidney disease (CKD) after heart transplantation (HT). All our HT patients 1988-2010 were considered for inclusion. Of these, 134 came for annual follow-ups including evaluation of glomerular filtration rate (GFR) using iohexol clearance measurements, and the CKD-EPI (adults) or Schwartz (children) formulae. Median GFR (Q1-Q3)(mL/min/1.73m(2) ) declined from 67.0 (50.0-82.0) during transplant assessment (TA), to 56.0 (45.0-69.0) at year 1, 53.0 (41.0-68.0) at year 5 and 44.5 (25.0-57.3) at year 10. The cumulative incidence of CKD ≥ stage 4 was 25% at 5 years and 41% at 10 years after transplantation. Proteinuria the first year post-HT was the only predictor related (p&lt;0.05) to a higher rate of GFR decline (HR 5.15, 95% CI 1.23-21.55). GFR ≥60 as compared to &lt;60 before HT, or a first year GFR decline &lt;30% as compared to &gt;30%, was moreover associated (p&lt;0.05) with a lower risk of death (HR 0.30, 95% CI 0.12-0.76 and HR 0.35, 95% CI 0.13-0.90, respectively). Notably, the CKD-EPI and Schwartz formulae overestimated GFR by 28±29% and 26±33%, respectively. In conclusion, CKD in HT patients is common and associated with worse outcome. To avoid diagnostic delay, GFR estimating equation's validity in HT patients needs further study. This article is protected by copyright. All rights reserved.},
  author       = {Söderlund, Carl and Löfdahl, Eveline and Nilsson, Johan and Reitan, Öyvind and Higgins, Thomas and Rådegran, Göran},
  issn         = {1432-2277},
  language     = {eng},
  number       = {5},
  pages        = {529--539},
  publisher    = {ARRAY(0xae43a28)},
  series       = {Transplant international : official journal of the European Society for Organ Transplantation},
  title        = {Chronic kidney disease after heart transplantation: a single-centre retrospective study at skåne university hospital in lund 1988-2010.},
  url          = {http://dx.doi.org/10.1111/tri.12710},
  volume       = {29},
  year         = {2016},
}