The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients

G. de Boccardo, J. Y. Kim, T. D. Schiano, R. Maurette, R. Gagliardi, B. Murphy, S. Emre, Enver Akalin

Research output: Contribution to journalArticle

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Abstract

Background: Chronic kidney disease (CKD) is an important risk factor for morbidity and mortality post-liver transplantation (OLT). This study focused on investigating the incidence and risk factors associated with the development CKD after OLT. Methods: We performed a retrospective cohort study of recipients followed at least 5 years at our institution. CKD was diagnosed and classified according to National Kidney Foundation and the Kidney Disease Outcomes Quality Initiative guidelines. Results: There were 231 patients, 64% men, 67% Caucasian, 16% African-American, and 17% others, with a mean age of 56 ± 13 years. The mean glomerular filtration rate (GFR) of the population was 56 ± 28 mL/min/1.73 m2. CKD was defined as GFR less than 60 mL/min; 144 patients (61%) were identified as having CKD. When these patients were compared to the non-CKD group, the former were significantly older (62 ± 9 vs 52 ± 12 years, P = .03), more likely to be hypertensive (59% vs 38%, P = .003), and required more antihypertensive medications (0.83 ± 0.81 vs 0.52 ± 0.77, P = .02); 26% of all patients had diabetes. However, the incidence of diabetes (43.3% vs 19.3%, P = .02) as well as the incidence of insulin dependency (21.6% vs 12.5%, P = .001) was significantly higher in the CKD population. Mean uric acid levels were higher in CKD patients compared to non-CKD patients (8.00 ± 2.00 mg/dL vs 6.70 ± 1.99 mg/dL respectively, P = .001); patients with uric acid more than 6.0 had a 1.7 risk of having CKD. Conclusions: CKD defined as GFR < 60 mL/min is highly prevalent in long-term OLT survivors. Older age, elevated systolic blood pressure, insulin-dependent diabetes mellitus, and elevated uric acid levels are independently associated with CKD.

Original languageEnglish (US)
Pages (from-to)1498-1503
Number of pages6
JournalTransplantation Proceedings
Volume40
Issue number5
DOIs
StatePublished - Jun 2008
Externally publishedYes

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Chronic Renal Insufficiency
Liver
Kidney Diseases
Uric Acid
Glomerular Filtration Rate
Incidence
Transplant Recipients
Blood Pressure
Type 1 Diabetes Mellitus
African Americans
Liver Transplantation
Antihypertensive Agents
Population
Survivors
Cohort Studies
Retrospective Studies
Guidelines
Insulin
Morbidity
Kidney

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

de Boccardo, G., Kim, J. Y., Schiano, T. D., Maurette, R., Gagliardi, R., Murphy, B., ... Akalin, E. (2008). The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients. Transplantation Proceedings, 40(5), 1498-1503. https://doi.org/10.1016/j.transproceed.2008.03.099

The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients. / de Boccardo, G.; Kim, J. Y.; Schiano, T. D.; Maurette, R.; Gagliardi, R.; Murphy, B.; Emre, S.; Akalin, Enver.

In: Transplantation Proceedings, Vol. 40, No. 5, 06.2008, p. 1498-1503.

Research output: Contribution to journalArticle

de Boccardo, G, Kim, JY, Schiano, TD, Maurette, R, Gagliardi, R, Murphy, B, Emre, S & Akalin, E 2008, 'The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients', Transplantation Proceedings, vol. 40, no. 5, pp. 1498-1503. https://doi.org/10.1016/j.transproceed.2008.03.099
de Boccardo G, Kim JY, Schiano TD, Maurette R, Gagliardi R, Murphy B et al. The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients. Transplantation Proceedings. 2008 Jun;40(5):1498-1503. https://doi.org/10.1016/j.transproceed.2008.03.099
de Boccardo, G. ; Kim, J. Y. ; Schiano, T. D. ; Maurette, R. ; Gagliardi, R. ; Murphy, B. ; Emre, S. ; Akalin, Enver. / The Burden of Chronic Kidney Disease in Long-Term Liver Transplant Recipients. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 5. pp. 1498-1503.
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abstract = "Background: Chronic kidney disease (CKD) is an important risk factor for morbidity and mortality post-liver transplantation (OLT). This study focused on investigating the incidence and risk factors associated with the development CKD after OLT. Methods: We performed a retrospective cohort study of recipients followed at least 5 years at our institution. CKD was diagnosed and classified according to National Kidney Foundation and the Kidney Disease Outcomes Quality Initiative guidelines. Results: There were 231 patients, 64{\%} men, 67{\%} Caucasian, 16{\%} African-American, and 17{\%} others, with a mean age of 56 ± 13 years. The mean glomerular filtration rate (GFR) of the population was 56 ± 28 mL/min/1.73 m2. CKD was defined as GFR less than 60 mL/min; 144 patients (61{\%}) were identified as having CKD. When these patients were compared to the non-CKD group, the former were significantly older (62 ± 9 vs 52 ± 12 years, P = .03), more likely to be hypertensive (59{\%} vs 38{\%}, P = .003), and required more antihypertensive medications (0.83 ± 0.81 vs 0.52 ± 0.77, P = .02); 26{\%} of all patients had diabetes. However, the incidence of diabetes (43.3{\%} vs 19.3{\%}, P = .02) as well as the incidence of insulin dependency (21.6{\%} vs 12.5{\%}, P = .001) was significantly higher in the CKD population. Mean uric acid levels were higher in CKD patients compared to non-CKD patients (8.00 ± 2.00 mg/dL vs 6.70 ± 1.99 mg/dL respectively, P = .001); patients with uric acid more than 6.0 had a 1.7 risk of having CKD. Conclusions: CKD defined as GFR < 60 mL/min is highly prevalent in long-term OLT survivors. Older age, elevated systolic blood pressure, insulin-dependent diabetes mellitus, and elevated uric acid levels are independently associated with CKD.",
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AU - Schiano, T. D.

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AU - Gagliardi, R.

AU - Murphy, B.

AU - Emre, S.

AU - Akalin, Enver

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N2 - Background: Chronic kidney disease (CKD) is an important risk factor for morbidity and mortality post-liver transplantation (OLT). This study focused on investigating the incidence and risk factors associated with the development CKD after OLT. Methods: We performed a retrospective cohort study of recipients followed at least 5 years at our institution. CKD was diagnosed and classified according to National Kidney Foundation and the Kidney Disease Outcomes Quality Initiative guidelines. Results: There were 231 patients, 64% men, 67% Caucasian, 16% African-American, and 17% others, with a mean age of 56 ± 13 years. The mean glomerular filtration rate (GFR) of the population was 56 ± 28 mL/min/1.73 m2. CKD was defined as GFR less than 60 mL/min; 144 patients (61%) were identified as having CKD. When these patients were compared to the non-CKD group, the former were significantly older (62 ± 9 vs 52 ± 12 years, P = .03), more likely to be hypertensive (59% vs 38%, P = .003), and required more antihypertensive medications (0.83 ± 0.81 vs 0.52 ± 0.77, P = .02); 26% of all patients had diabetes. However, the incidence of diabetes (43.3% vs 19.3%, P = .02) as well as the incidence of insulin dependency (21.6% vs 12.5%, P = .001) was significantly higher in the CKD population. Mean uric acid levels were higher in CKD patients compared to non-CKD patients (8.00 ± 2.00 mg/dL vs 6.70 ± 1.99 mg/dL respectively, P = .001); patients with uric acid more than 6.0 had a 1.7 risk of having CKD. Conclusions: CKD defined as GFR < 60 mL/min is highly prevalent in long-term OLT survivors. Older age, elevated systolic blood pressure, insulin-dependent diabetes mellitus, and elevated uric acid levels are independently associated with CKD.

AB - Background: Chronic kidney disease (CKD) is an important risk factor for morbidity and mortality post-liver transplantation (OLT). This study focused on investigating the incidence and risk factors associated with the development CKD after OLT. Methods: We performed a retrospective cohort study of recipients followed at least 5 years at our institution. CKD was diagnosed and classified according to National Kidney Foundation and the Kidney Disease Outcomes Quality Initiative guidelines. Results: There were 231 patients, 64% men, 67% Caucasian, 16% African-American, and 17% others, with a mean age of 56 ± 13 years. The mean glomerular filtration rate (GFR) of the population was 56 ± 28 mL/min/1.73 m2. CKD was defined as GFR less than 60 mL/min; 144 patients (61%) were identified as having CKD. When these patients were compared to the non-CKD group, the former were significantly older (62 ± 9 vs 52 ± 12 years, P = .03), more likely to be hypertensive (59% vs 38%, P = .003), and required more antihypertensive medications (0.83 ± 0.81 vs 0.52 ± 0.77, P = .02); 26% of all patients had diabetes. However, the incidence of diabetes (43.3% vs 19.3%, P = .02) as well as the incidence of insulin dependency (21.6% vs 12.5%, P = .001) was significantly higher in the CKD population. Mean uric acid levels were higher in CKD patients compared to non-CKD patients (8.00 ± 2.00 mg/dL vs 6.70 ± 1.99 mg/dL respectively, P = .001); patients with uric acid more than 6.0 had a 1.7 risk of having CKD. Conclusions: CKD defined as GFR < 60 mL/min is highly prevalent in long-term OLT survivors. Older age, elevated systolic blood pressure, insulin-dependent diabetes mellitus, and elevated uric acid levels are independently associated with CKD.

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