Non-Renal Risk Factors for Chronic Kidney Disease in Liver Recipients with Functionally Intact Kidneys at 1 Month

Author:

Kim Deok-Gie,Hwang Shin,Kim Jong ManORCID,Ryu Je Ho,You Young KyoungORCID,Choi Donglak,Kim Bong-Wan,Kim Dong-SikORCID,Nah Yang WonORCID,Kim Tae-Seok,Cho Jai YoungORCID,Hong Geun,Yang Jae DoORCID,Han Jaryung,Suh Suk-Won,Kim Kwan WooORCID,Jung Yun Kyung,Moon Ju Ik,Lee Jun YoungORCID,Kim Sung HwaORCID,Lee Jae GeunORCID,Kim Myoung SooORCID,Lee Kwang-WoongORCID,Joo Dong JinORCID

Abstract

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.

Funder

Korea Center for Disease Control and Prevention

Publisher

MDPI AG

Subject

General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. How to prevent chronic kidney disease after liver transplantation?;Annals of Liver Transplantation;2024-05-16

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