Dataset Information

Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation.

ABSTRACT:

Background

Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD.

Methods

LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation.

Results

During the study period, 111 patients were lung transplant candidates, of which 91 had a pre-transplantation mGFR, and 29 had a mGFR at 1 year after LT. Six patients underwent maintenance haemodialysis after transplantation. Mean mGFR was 106 mL/min/1.73 m² before LT and 58 mL/min/1.73 m² 1 year after LT (P < 0.05) with a mean loss of 48 mL/min/1.73 m² per patient. The risk of developing Stage ≥3 CKD after LT was higher in patients with lower pre-LT mGFR (odds ratio for each 1 mL/min/1.73 m² increase: 0.94, 95% confidence interval 0.88-0.99). Receiver operator characteristics curves for the sensitivity and specificity of eGFR and mGFR for the prediction of CKD Stage ≥3 after LT found that pre-LT mGFR of 101 mL/min/1.73 m² and pre-LT eGFR of 124 mL/min/1.73 m² were the optimal thresholds for predicting Stage ≥3 CKD after LT.

Conclusion

The present study underlines the value of mGFR in the pre-LT stage and found major renal function loss after LT, and consequently two-thirds of patients have Stage ≥3 CKD at 1 year. All patients with a pre-LT mGFR <90 mL/min/1.73 m² warrant particular attention.

SUBMITTER: Florens N

PROVIDER: S-EPMC7577765 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation.

Florens Nans N Dubourg Laurence L Bitker Laurent L Kalbacher Emilie E Philit François F Mornex Jean François JF Parant François F Guebre-Egziabher Fitsum F Juillard Laurent L Lemoine Sandrine S

Clinical kidney journal 20200509 5

<h4>Background</h4>Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD.<h4>Methods</h4>LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation.<h4>Res ...[more]

PMID: 33123359

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Project description:Background and objectivesAnimal studies suggest that microvascular rarefaction is a key factor in the acute kidney disease to CKD transition. Hence, delayed graft function appears as a unique human model of AKI to further explore the role of microvascular rarefaction in kidney transplant recipients. Here, we assessed whether delayed graft function is associated with peritubular capillary loss and evaluated the association between this loss and long-term kidney graft function.Design, setting, participants, & measurementsThis observational, retrospective cohort study included 61 participants who experienced delayed graft function and 130 who had immediate graft function. We used linear regression models to evaluate associations between delayed graft function and peritubular capillary density expressed as the percentage of efficient cortical area occupied by peritubular capillaries in pre- and post-transplant graft biopsies. eGFRs 1 and 3 years post-transplant were secondary outcomes.ResultsPost-transplant biopsies were performed at a median of 113 days (interquartile range, 101-128) after transplantation. Peritubular capillary density went from 15.4% to 11.5% in patients with delayed graft function (median change, -3.7%; interquartile range, -6.6% to -0.8%) and from 19.7% to 15.1% in those with immediate graft function (median change, -4.5%; interquartile range, -8.0% to -0.8%). Although the unadjusted change in peritubular capillary density was similar between patients with and without delayed graft function, delayed graft function was associated with more peritubular capillary loss in the multivariable analysis (adjusted difference in change, -2.9%; 95% confidence interval, -4.0 to -1.8). Pretransplant peritubular capillary density and change in peritubular capillary density were associated with eGFR 1 and 3 years post-transplantation.ConclusionsPerioperative AKI is associated with lower density in peritubular capillaries before transplantation and with loss of peritubular capillaries following transplantation. Lower peritubular capillary density is linked to lower long-term eGFR.

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Dataset Information

Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation.

Background

Methods

Results

Conclusion

Publications

Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation.

Similar Datasets

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