Early kidney dysfunction post liver transplantation predicts late chronic kidney disease.

摘要: BACKGROUND Acute and chronic renal dysfunction (ARD, CRD) are common complications after liver transplantation associated with poor outcome. METHODS We reviewed the results of 181 transplants performed in our institution between January 1, 1998 December 31, 2000 which recipients were alive good function at end follow-up period (mean 2.7 years). Renal was defined as a serum creatinine (Cr) greater than or equal to 2 mg/dL both acute settings. RESULTS The incidence ARD during first posttransplant week 39.2% (n=71), whereas late CRD occurred 6.0% (n=11) patients by period. Among variables we examined for association CRD, five factors found be statistically significant univariate analysis: pretransplant diabetes (PRTDM) (0.000), Cr postoperative (0.003), (POTDM) (0.014), age 50 (0.025), tacrolimus level 15 ng/mL day (0.058). In binary logistic regression analysis, PRTDM (odds ratio [OR]=5.7, 95% confidence interval [CI]) early (OR=10.2 CI) remained consistently significant. Nine 11 also had history week. These progressed despite fact that seven nine normalized their 90 posttransplant. CONCLUSION suggest combination events transplant serve physiologic "stress test" kidneys. Patients who fail test (peak >/=2 week) well mellitus increased risk CRD. such cases, conversion less nephrotoxic regimen may beneficial.