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Non-Renal Risk Factors for Chronic Kidney Disease in Liver Recipients with Functionally Intact Kidneys at 1 Month

 Deok-Gie Kim  ;  Shin Hwang  ;  Jong Man Kim  ;  Je Ho Ryu  ;  Young Kyoung You  ;  Donglak Choi  ;  Bong-Wan Kim  ;  Dong-Sik Kim  ;  Yang Won Nah  ;  Tae-Seok Kim  ;  Jai Young Cho  ;  Geun Hong  ;  Jae Do Yang  ;  Jaryung Han  ;  Suk-Won Suh  ;  Kwan Woo Kim  ;  Yun Kyung Jung  ;  Ju Ik Moon  ;  Jun Young Lee  ;  Sung Hwa Kim  ;  Jae Geun Lee  ;  Myoung Soo Kim  ;  Kwang-Woong Lee  ;  Dong Jin Joo 
 JOURNAL OF CLINICAL MEDICINE, Vol.11(14) : 4203, 2022-07 
Journal Title
Issue Date
chronic kidney disease ; liver transplantation ; renal dysfunction
Chronic kidney disease (CKD) is a critical complication of liver transplants, of which non-renal risk factors are not fully understood yet. This study aimed to reveal pre- and post-transplant risk factors for CKD (<60 mL/min/1.73 m2), examining liver recipients with functionally intact kidneys one month after grafting using nationwide cohort data. Baseline risk factors were analyzed with multivariable Cox regression analyses and post-transplant risk factors were investigated with the time-dependent Cox model and matched analyses of time-conditional propensity scores. Of the 2274 recipients with a one-month eGFR ≥ 60 mL/min/1.73 m2, 494 (22.3%) developed CKD during a mean follow-up of 36.6 ± 14.4 months. Age, female sex, lower body mass index, pre-transplant diabetes mellitus, and lower performance status emerged as baseline risk factors for CKD. Time-dependent Cox analyses revealed that recurrent hepatocellular carcinoma (HR = 1.93, 95% CI 1.06-3.53) and infection (HR = 1.44, 95% CI 1.12-1.60) were significant post-transplant risk factors for CKD. Patients who experienced one of those factors showed a significantly higher risk of subsequent CKD compared with the matched controls who lacked these features (p = 0.013 for recurrent hepatocellular carcinoma, and p = 0.003 for infection, respectively). This study clarifies pre- and post-transplant non-renal risk factors, which lead to renal impairment after LT independently from patients' renal functional reserve.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deok Gie(김덕기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
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