作者
Deok-Gie Kim, Shin Hwang, Jong Man Kim, Je Ho Ryu, Young Kyoung You, Donglak Choi, Bong-Wan Kim, Dong-Sik Kim, Yang Won Nah, Tae-Seok Kim, Jai Young Cho, Geun Hong, Jae Do Yang, Jaryung Han, Suk-Won Suh, Kwan Woo Kim, Yun Kyung Jung, Ju Ik Moon, Jun Young Lee, Sung Hwa Kim, Jae Geun Lee, Myoung Soo Kim, Kwang-Woong Lee, Dong Jin Joo
发表日期
2022/7/20
期刊
Journal of Clinical Medicine
卷号
11
期号
14
页码范围
4203
出版商
MDPI
简介
Chronic kidney disease (CKD) is a critical complication of liver transplants, of which non-renal risk factors are not fully understood yet. This study aimed to reveal pre- and post-transplant risk factors for CKD (<60 mL/min/1.73 m2), examining liver recipients with functionally intact kidneys one month after grafting using nationwide cohort data. Baseline risk factors were analyzed with multivariable Cox regression analyses and post-transplant risk factors were investigated with the time-dependent Cox model and matched analyses of time-conditional propensity scores. Of the 2274 recipients with a one-month eGFR ≥ 60 mL/min/1.73 m2, 494 (22.3%) developed CKD during a mean follow-up of 36.6 ± 14.4 months. Age, female sex, lower body mass index, pre-transplant diabetes mellitus, and lower performance status emerged as baseline risk factors for CKD. Time-dependent Cox analyses revealed that recurrent hepatocellular carcinoma (HR = 1.93, 95% CI 1.06–3.53) and infection (HR = 1.44, 95% CI 1.12–1.60) were significant post-transplant risk factors for CKD. Patients who experienced one of those factors showed a significantly higher risk of subsequent CKD compared with the matched controls who lacked these features (p = 0.013 for recurrent hepatocellular carcinoma, and p = 0.003 for infection, respectively). This study clarifies pre- and post-transplant non-renal risk factors, which lead to renal impairment after LT independently from patients’ renal functional reserve.
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