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Acta Gastroenterol Latinoam. 2014;44(4):316-22.

Early predictors of renal dysfunction in cirrhotic patients after liver transplantation.

Abstract

BACKGROUND:

Assessment of renal function 12 months after liver transplantation (LT) predicts chronic renal failure on long-term follow up.

OBJECTIVE:

To evaluate pre- and post- LT factors associated with development of renal dysfunction (RD) in cirrhotic patients.

METHODS:

Between June 2005 and June 2010, 104 cirrhotic patients were selected from 268 consecutively transplanted adult patients. RD was defined as a calculated glomerular filtration rate (cGFR) < 50 ml/min/1.73m2 by modification of diet in renal disease (MDRD), 12 months after LT.

RESULTS:

Baseline pre-LT creatinine was 1.0 ± 0.7 mg/dL and cGFR was 64 ± 32.8 mL/min. At 12 month follow up, creatinine was 1.3 ± 0.6 mg/dL and cGFR was 47 ± 18 mL/min. The prevalence of RD was 55%. Variables related to RD on univariate analysis were age (P = 0.007), pre-L T GFR (P = 0.012) and 7th day post-L T GFR (P = 0.003). Risk factors associated with RD on multivariate stepwise regression analysis were patient age [Odds ratio (OR) 1.04 (95% confidence interval (CI) 0.99- 1.09, P = 0.06)] and 7 day post-LT GFR [OR 0.97 (95% CI 0.96-0.99, P = 0.013)]. ROC curve analysis for 7th day post-LT GFR was 0.71 (95% CI 0.61-0.81).

CONCLUSION:

The 7th day post-LT GFR in cirrhotic patients may be a useful clinical tool to identify which patients might benefit from earlier nephroprotective immunosuppression.

PMID:
26753383
[Indexed for MEDLINE]

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