Chronic kidney disease after liver transplantation: Recent evidence

Fabrizio Fabrizi, Vivek Dixit, Paul Martin, Piergiorgio Messa

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Chronic kidney disease is a common complication after liver transplantation with an incidence ranging between 20% and 80%. Studies of renal function after liver transplantation have yielded conflicting results: the wide range in incidence rates of chronic kidney disease (CKD) following liver transplantation is related to the methods for measuring kidney function, and various criteria for defining renal dysfunction, among others. An important cause of CKD among liver transplant recipients is calcineurin inhibitor-based immunosuppression. Additional predictors of CKD post-liver transplantation include pre-transplant kidney function, peri-operative acute kidney failure, age, and hepatitis C. A recent meta-analysis of observational studies revealed that, in the subgroup of studies provided with glomerular filtration rate at baseline, the summary estimate of relative risk and 95% confidence intervals (CI) for developing chronic renal failure among liver transplant recipients with diminished renal function at transplant was 2.12 (95% CI, 1.01-4.46, p=0.047). Acute renal insufficiency is common immediately after liver transplantation, whereas the course of CKD after liver transplantation appears progressive over time. Only preliminary information exists on kidney pathological findings in recipients of liver transplants with CKD. Introduction of the Model for End-stage Liver Disease for the allocation of liver grafts has not increased the occurrence of renal dysfunction following liver transplantation. Chronic kidney disease following liver transplantation increases cardiovascular burden dramatically. The use of mycophenolic acid- or sirolimus-based immunosuppression in calcineurin-inhibitors sparing protocols is an area of intense research.

Original languageEnglish
Pages (from-to)803-811
Number of pages9
JournalInternational Journal of Artificial Organs
Volume33
Issue number11
StatePublished - Nov 1 2010

Fingerprint

Chronic Renal Insufficiency
Liver
Liver Transplantation
Kidney
Transplants
Acute Kidney Injury
Immunosuppression
Confidence Intervals
Mycophenolic Acid
End Stage Liver Disease
Incidence
Sirolimus
Hepatitis C
Glomerular Filtration Rate
Chronic Kidney Failure
Observational Studies
Meta-Analysis
Transplantation (surgical)
Grafts
Research

Keywords

  • Chronic kidney disease
  • Glomerular filtration rate
  • Hepatitis C virus
  • Liver transplantation
  • Survival

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this

Chronic kidney disease after liver transplantation : Recent evidence. / Fabrizi, Fabrizio; Dixit, Vivek; Martin, Paul; Messa, Piergiorgio.

In: International Journal of Artificial Organs, Vol. 33, No. 11, 01.11.2010, p. 803-811.

Research output: Contribution to journalArticle

Fabrizi, Fabrizio ; Dixit, Vivek ; Martin, Paul ; Messa, Piergiorgio. / Chronic kidney disease after liver transplantation : Recent evidence. In: International Journal of Artificial Organs. 2010 ; Vol. 33, No. 11. pp. 803-811.
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