Kidney disease in non-kidney solid organ transplantation

Table 4 Kidney disease after lung

Ref.	Total number of patients, n	Risk factors associated with kidney disease	Study conclusion
Ojo et al[2]	7644		2.9% incidence of CKD IV/V at 12 mo and 15.8% incidence of GFR < 30 mL/min/1.73 m2 at 5 yr post lung transplant
Rocha et al[41]	296	AKI: Baseline GFR (OR = 0.98, 95%CI: 0.96-0.99, P = 0.012), pulmonary diagnosis other than COPD (OR = 6.80, 95%CI: 1.5-30.89, P = 0.013), mechanical ventilation > 1 d (OR = 6.16, 95%CI: 1.70-22.24, P = 0.006) and parenteral amphotericin B use (OR = 3.04, 95%CI: 1.03-8.98, P = 0.045)	AKI rate of 56% (n = 166). Patient survival by AKI and AKI requiring RRT with one-year survival no AKI = 92.3%, AKI w/o RRT = 81.8% and AKI w/RRT 21.7% (P < 0.0001). At 5 (61%, 58% and 13%) and 10 yr (59%, 55% and 13%). Single lung transplant (HR = 1.78, 95%CI: 1.24-2.55, P = 0.0018) and AKI requiring RRT (HR = 6.77, 95%CI: 4.00-11.44, P < 0.0001) associated with mortality
Broekroelofs et al[42]	57	Highest median GFR in the CF recipients (-10 mL/min/year, range -14 to -6 mL/min/year), compared to those w/emphysema (-6 mL/min/year, range -27 to +12 mL/min/year) and pHTN (-1 mL/min/year, range -6 to +7 mL/min/year)	Nearly 50% decrease in mGFR at 36 mo post transplantation (100 mL/min pre-transplant vs 51 mL/min at 36 mo post-transplant)
Mason et al[44]	425	Lower creatinine clearance (P = 0.03) and greater recipient height (P = 0.0002)	HD prevalence = 0.6%, 4%, 9%, 13%, 16% and 19%, at 30 d and 1, 3, 5, 7 and 9 yr post-transplant. Mortality risk after ESRD was 100%, 17% and 3.1% per year at 3 mo, 1 yr and 3 yr, respectively. In other words, median survival after starting dialysis was 5 mo
Canales et al[45]	186	Older age, lower 1 mo GFR and CSA use in the first 6 mo were associated with faster doubling of serum creatinine (all P < 0.05)	At 1 and 7 yr, the prevalence of CKD IV (81 and 95 times) and V (10 and 20 times) were substantially higher in the lung, heart-lung transplant recipients than the general population as described by NHANES III; AKI episodes (RR = 1.6, 95%CI: 1.2-2.0, P < 0.001), and older age at transplant (RR = 1.02, 95%CI: 1.008-1.04), P = 0.004) were significant predictors of death
Ishani et al[9]	186	DBP than 90 mmHg (RR = 1.30, 95%CI: 1.05-1.60, P = 0.02), 1 mo post-transplant Cr (RR = 1.28, 95%CI: 1.02-1.70, P =0.03) were associated with increased risk to time to doubling baseline SCr	Cause of lung failure, age at transplant, nor rejection were significantly associated with doubling of Cr. Tacrolimus use in the first 6 mo after transplant was associated with a decreased in the risk for doubling time of SCr (RR = 0.38, 95%CI: 0.19-0.79, P = 0.0009)
Paradela de la Morena et al[46]	161	Older age (OR = 2.0; P < 0.001) and CMV infection (OR = 2.2; P = 0.045)	68.6% of the cohort developed CKD; CKD at 1 yr was associated with increased mortality compared to those without CKD (P = 0.001)

CKD: Chronic kidney disease; GFR: Glomerular filtration rate; Cr: Creatinine; COPD: Chronic obstructive pulmonary disease; CI: Confidence interval; OR: Odds ratio; AKI: Acute kidney injury; RRT: Renal replacement therapy; HR: Hazard ratio; CF: Cystic fibrosis; pHTN: Portal hypertension; mGFR: Measured glomerular filtration rate; ESRD: End stage renal disease; CSA: Cyclosporine; AKI: Acute kidney injury; RR: Relative risk; CI: Confidence interval; DBP: Diastolic blood pressure; SCr: Serum creatinine; CMV: Cytomegalovirus.