Renal dysfunction after heart transplantation: Incidence, prognosis and risk factors
Journal
Journal of the Formosan Medical Association
Journal Volume
104
Journal Issue
7
Pages
482-486
Date Issued
2005
Author(s)
Abstract
Background and Purpose: Despite more than 20 years of experience in heart transplantation, the risk factors for development of chronic renal insufficiency in recipients are not well established. This study assessed the incidence, prognosis and risk factors for renal dysfunction after heart transplantation. Methods: We conducted a retrospective analysis of all adult patients (n = 132) who survived for more than 1 year after heart transplantation at our institutions from March 1992 through November 2002. Renal dysfunction was defined as serum creatinine of ? 2.0 mg/dL. The incidence and prognosis of renal dysfunction after heart transplantation was estimated by the Kaplan-Meier method and compared by log rank test. Risk factors for renal dysfunction at 1 year after transplantation were evaluated using a logistic regression model. Results: Renal dysfunction was present in 9 patients (7%) before heart transplantation. The cumulative incidence of renal dysfunction after heart transplantation was 23.0 ± 3.8%, 36.1 ± 4.3%, 53.9 ± 4.9%, and 57.3 ± 5.8% at 6 months, 1 year, 5 years and 10 years, respectively, after transplantation. The actuarial survival rate in patients without renal dysfunction at 1 year after transplantation was better than for patients with renal dysfunction at 1 year after transplantation (p = 0.046 by log-rank test). Independent risk factors for renal dysfunction at 1 year after transplantation were age at transplantation (odds ratio, 1.07; p = 0.02), pretransplant serum blood urea nitrogen (odds ratio, 1.07; p = 0.048), and serum creatinine at 6 months after transplantation (odds ratio, 17.0; p < 0.001). Conclusions: There was a high incidence of renal dysfunction after heart transplantation. Patients with renal dysfunction had poor long-term prognosis. Serum creatinine at 6 months after transplantation was the most significant major risk factor, followed by age at transplantation and pretransplant blood urea nitrogen.
SDGs
Other Subjects
creatinine; creatinine; cyclosporin; adolescent; adult; aged; article; controlled study; creatinine blood level; female; heart transplantation; human; incidence; kidney disease; major clinical study; male; prognosis; risk factor; school child; survival rate; urea nitrogen blood level; blood; child; heart transplantation; kidney disease; middle aged; mortality; retrospective study; Adolescent; Adult; Aged; Child; Creatinine; Cyclosporine; Female; Heart Transplantation; Humans; Incidence; Kidney Diseases; Male; Middle Aged; Prognosis; Retrospective Studies; Risk Factors
Type
journal article