TY - JOUR
T1 - Renal dysfunction after heart transplantation
T2 - Incidence, prognosis and risk factors
AU - Hsu, Ron B.
AU - Chen, Robert J.
AU - Lin, Cheng Hsin
AU - Chou, Nai Kuan
AU - Ko, Wen J.
AU - Wang, Shoei Shen
AU - Chu, Shu Hsun
PY - 2005/7
Y1 - 2005/7
N2 - 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.
AB - 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.
KW - Heart transplantation
KW - Incidence
KW - Kidney failure
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=24944525847&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24944525847&partnerID=8YFLogxK
M3 - Article
C2 - 16091824
AN - SCOPUS:24944525847
SN - 0929-6646
VL - 104
SP - 482
EP - 486
JO - Journal of the Formosan Medical Association = Taiwan yi zhi
JF - Journal of the Formosan Medical Association = Taiwan yi zhi
IS - 7
ER -