Kidney disease in non-kidney solid organ transplantation

Table 3 Kidney disease after heart

Ref.	Total number of patients, n	Risk factors associated with kidney disease	Study conclusion
Ojo et al[2]	24024	Systemic atherosclerosis, renal hypoperfusion from cardiorenal disease	Perioperative acute renal failure rate of 20%-30% of heart transplant recipients with a 10.9% CKD IV/V rate at 60 mo post-transplant
Cantarovich et al[39]	233	30% in CrCl between 1 mo and 3 mo independently predicted the need for chronic dialysis (P = 0.04) and time to first CrCl < 30 mL/min at > 1 yr after transplant (P = 0.01)	Early renal dysfunction predicts poor long term kidney outcomes
Rubel et al[40]	370	Multivariate analysis: GFR < 50 mL/min (HR = 3.69, P = 0.024); high mean cyclosporine trough in the first 6 mo (HR = 5.10, P = 0.0059); and presence of diabetes (HR = 3.53, P = 0.021)	Mean eGFR fell 24% at year one, 23% of patients developed a 50% reduction in GFR by year 3, and that 20% of the cohort developed ESRD at 10 yr post-transplant
Lindelöw et al[37]	151	Age	The average preoperative GFR of 66 ± 17 mL/min per 1.73 m2 declined to 52 ± 19 (P < 0.0001) at 1 yr. From 2 yr to 9 yr after heart transplantation, overall kidney function remained fairly stable (all P > 0.05)
Boyle et al[14]	756	Insulin dependent diabetes (P = 0.019) and prior cardiac surgery (P = 0.014)	AKI rate of 5.8% (44 of 756); they observed a 50% (22/44) mortality rate in OHTs with AKI requiring dialysis compared to those who did not have AKI (1.4%, 10/712)
Hamour et al[8]	352	Post-operative RRT for AKI, P < 0.001; pretransplant diabetes (P = 0.005); increasing recipient age, (P < 0.001); female recipient, (P = 0.029) and female donor (P = 0.04) associated for progression to eGFR < 45. CSA not associated	Cumulative probability of eGFR < 45 mL/min/1.73 m2 over time was the following: 45% at year 1, 71% at year 5 and 83% at year 10
Wyatt and Arons[31]	141		Postoperative AKI, especially that requiring RRT, was associated with increased mortality (aOR = 8.96, 95%CI: 1.75-45.80, P = 0.008)

CKD: Chronic kidney disease; CrCl: Creatinine clearance; GFR: Glomerular filtration rate; HR: Hazard ratio; eGFR: Estimated glomerular filtration rate; ESRD: End stage renal disease; AKI: Acute kidney injury; OHT: Orthotopic heart transplant; RRT: Renal replacement therapy; CSA: Cyclosporine; CI: Confidence interval; aOR: Adjusted odds ratio.