In:
Journal of Nephrology, Springer Science and Business Media LLC, Vol. 35, No. 7 ( 2022-07-15), p. 1885-1893
Abstract:
The clinical trajectory of post-operative acute kidney injury (AKI) following lung transplantation for cystic fibrosis is unknown. Methods Incidence and risk factors for post-operative AKI, acute kidney disease (AKD) and chronic kidney disease (CKD) were retrospectively analyzed in cystic fibrosis patients undergoing lung transplantation. Logistic regressions, Chi-square, Cuzick rank tests, and Cox-proportional hazard models were used. Results Eighty-three patients were included. Creatinine peaked 3[2–4] days after transplantation, with 15(18%), 15(18%), and 20(24%) patients having post-operative AKI stages 1, 2, and 3, while 15(18%), 19(23%) and 10(12%) developed AKD stage 1, stage 2 and 3, respectively. Higher AKI stage was associated with worsening AKD ( p = 0.009) and CKD ( p = 0.015) stages. Of the 50 patients with AKI, 32(66%) transitioned to AKD stage 〉 0, and then 27 (56%) to CKD stage 〉 1. Female sex, extracorporeal membrane oxygenation support as a bridge to lung transplant and at the end of the surgery, the use of intraoperative blood components, and cold-ischemia time were associated with increased risk of post-operative AKI and AKD. Higher AKI stage prolonged invasive mechanical ventilation ( p = 0.0001), ICU stay ( p = 0.0001), and hospital stay ( p = 0.0001), and increased the incidence of primary graft dysfunction ( p = 0.035). Both AKI and AKD stages 〉 2 worsened long-term survival with risk ratios of 3.71 (1.34–10.2), p = 0.0131 and 2.65(1.02–6.87), p = 0.0443, respectively. Discussion AKI is frequent in cystic fibrosis patients undergoing lung transplantation, it often evolves to AKD and to chronic kidney disease, thereby worsening short- and long-term outcomes. Graphical abstract
Type of Medium:
Online Resource
ISSN:
1724-6059
DOI:
10.1007/s40620-022-01392-z
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
1475007-7
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