Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT).

Data de publicació: 15/06/2023 Data Ahead of Print: 15/06/2023

Autors de IIS La Fe

• Julio Hernández Jaras

  Autor

Autors aliens a IIS La Fe

• Viejo-Boyano, Iris
• Lopez-Romero, Luis Carlos
• D'Marco, Luis
• Checa-Ros, Ana
• Peris-Fernandez, Maria
• Garrigos-Almerich, Enrique
• Ramos-Tomas, Maria Carmen
• Peris-Domingo, Ana

Grups d'Investigació

• Farmacogenética

  Investigador Principal

  María José Herrero Cervera

• Unidad Mixta de Investigación en Nanomedicina y Sensores

  Leader

  Ramón Martínez Máñez

Abstract

Background: Chronic kidney disease (CKD) is a common complication of a non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD patients under follow-up in the Nephrology Department between 2010 to 2020. Statistical analysis was performed between all the risk factors and four dependent variables: end-stage renal disease (ESKD); increased serum creatinine & GE;50%; renal replacement therapy (RRT); and death in the pre-transplant, peri-transplant, and post-transplant periods. Results: 74 patients were studied (7 heart transplants, 34 liver transplants, and 33 lung transplants). Patients who were not followed-up by a nephrologist in the pre-transplant (p < 0.027) or peri-transplant (p < 0.046) periods and those who had the longest time until an outpatient clinic follow-up (HR 1.032) were associated with a higher risk of creatinine increase & GE;50%. Receiving a lung transplant conferred a higher risk than a liver or heart transplant for developing a creatinine increase & GE;50% and ESKD. Peri-transplant mechanical ventilation, peri-transplant and post-transplant anticalcineurin overdose, nephrotoxicity, and the number of hospital admissions were significantly associated with a creatinine increase & GE;50% and developing ESKD. Conclusions: Early and close follow-up by a nephrologist was associated with a decrease in the worsening of renal function.

Keywords

• chronic kidney disease; end-stage renal disease; solid organ transplant; nephrology