Post-liver transplant acute renal failure: Factors predicting development of end-stage renal disease

Anil S. Paramesh, Sasan Roayaie, Yvette Doan, Myron E. Schwartz, Sukru Emre, Thomas Fishbein, Sander Florman, Gabriel E. Gondolesi, Nancy Krieger, Scott Ames, Jonathan S. Bromberg, Enver Akalin

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Abstract

Background: Acute renal failure (ARF) occurs in 5-50% of patients undergoing orthotopic liver transplantation (OLT). The aim of this study was to determine factors that might predict the development of end stage renal disease (ESRD) in patients who had ARF after OLT. Methods: We studied all OLT recipients between 9/1/1988 through 12/31/2000. Results: A total of 1602 patients underwent OLT during the study period. About 350 patients (22%) developed ARF requiring dialysis post-operatively. One hundred and twenty-three (39.8%) died within a year after OLT. Median follow up was 5.8 yr (range 1-12 yr). Forty-three patients (23%) developed ESRD over median of 3.79 yr (range 1-8 yr). Multivariate logistic regression analysis revealed creatinine levels > 1.7 mg/dL at 1 yr (p < 0.001), cyclosporine as immunosuppression (p = 0.026), and the presence of diabetes pre-OLT (p < 0.001) to be associated with the development of ESRD. The development of ESRD did not decrease patient survival (p = 0.111). ESRD patients who received subsequent kidney transplantation had significantly improved survival rates (p = 0.005). Conclusions: Serum creatinine levels at 1 yr, cyclosporine as immunosuppression, and the presence of diabetes pre-OLT are independent predictive factors for the development of ESRD. ESRD patients who received kidney transplantation had higher 10-yr survival rates when compared with patients maintained on dialysis.

Original languageEnglish (US)
Pages (from-to)94-99
Number of pages6
JournalClinical Transplantation
Volume18
Issue number1
DOIs
Publication statusPublished - Feb 1 2004
Externally publishedYes

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Keywords

  • Acute renal failure
  • Cyclosporine
  • Dialysis
  • End-stage renal disease
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

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