Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT)

Author:

Viejo-Boyano Iris1ORCID,López-Romero Luis Carlos2ORCID,D’Marco Luis3ORCID,Checa-Ros Ana3ORCID,Peris-Fernández María1,Garrigós-Almerich Enrique1,Ramos-Tomás María Carmen1,Peris-Domingo Ana1,Hernández-Jaras Julio1ORCID

Affiliation:

1. Nephrology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain

2. Nephrology Department, Hospital General Universitario de Valencia, 46014 Valencia, Spain

3. Grupo de Investigación en Enfermedades Cardiorrenales y Metabólicas, Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain

Abstract

Background: Chronic kidney disease (CKD) is a common complication of a non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD patients under follow-up in the Nephrology Department between 2010 to 2020. Statistical analysis was performed between all the risk factors and four dependent variables: end-stage renal disease (ESKD); increased serum creatinine ≥50%; renal replacement therapy (RRT); and death in the pre-transplant, peri-transplant, and post-transplant periods. Results: 74 patients were studied (7 heart transplants, 34 liver transplants, and 33 lung transplants). Patients who were not followed-up by a nephrologist in the pre-transplant (p < 0.027) or peri-transplant (p < 0.046) periods and those who had the longest time until an outpatient clinic follow-up (HR 1.032) were associated with a higher risk of creatinine increase ≥50%. Receiving a lung transplant conferred a higher risk than a liver or heart transplant for developing a creatinine increase ≥50% and ESKD. Peri-transplant mechanical ventilation, peri-transplant and post-transplant anticalcineurin overdose, nephrotoxicity, and the number of hospital admissions were significantly associated with a creatinine increase ≥50% and developing ESKD. Conclusions: Early and close follow-up by a nephrologist was associated with a decrease in the worsening of renal function.

Funder

Valencian Society of Nephrology by “María Isabel Buches” grant for research in Nephrology

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

Reference23 articles.

1. Chronic Kidney Disease after Nonrenal Solid-Organ Transplantation;Bloom;J. Am. Soc. Nephrol.,2007

2. Chronic Kidney Disease in Solid-Organ Transplantation;Miller;Adv. Chronic Kidney Dis.,2006

3. Chronic Renal Failure after Transplantation of a Nonrenal Organ;Ojo;N. Engl. J. Med.,2003

4. Registro español de Trasplante Cardiaco. XXX Informe oficial de la Sección de Insuficiencia Cardiaca de la SEC (1984–2018);Rev. Esp. Cardiol.,2019

5. (2022, December 01). Memoria de Resultados del Registro Español de Trasplante Hepático. Available online: http://www.sethepatico.org.

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