Patients who experience acute kidney injury (AKI) after receiving a liver transplant and do not recover renal function within 90 days after surgery are at an increased risk for chronic kidney disease (CKD), according to study investigators.
The study included 392 patients who underwent liver transplantation from January 2003 to January 2019 (mean age 54.1 years, 77.3% men), of whom 243 (62%) experienced AKI within 7 days after surgery. Compared with the no-AKI group, the AKI group had a 1.6-fold increased risk for incident CKD in adjusted analyses.
Among the patients who had AKI, 160 (65.8%) recovered renal function and 83 (34.2%) did not. Compared with the no-AKI group, the AKI non-recovery group had a significant 2.9-fold increased risk for incident CKD in adjusted analyses, whereas those who recovered renal function did not differ in the risk for incident CKD, corresponding author Yao-Peng Hsieh, MD, of Changhua Christian Hospital in Changhua, Taiwan, and colleagues reported in Nephrology Dialysis Transplantation. In addition, compared with the AKI-recovery group, the AKI non-recovery group had a significant 2.6-fold increased risk for incident CKD.
The AKI recovery group included patients whose estimated glomerular filtration rate (eGFR) recovered to more than 90% of baseline eGFR within 90 days after surgery. The investigators defined CKD as an eGFR less than 60 mL/min/1.73 m2.
“Identification and implementation of targeted and individualized therapies for patients at risk for AKI, particularly non-recovery AKI, is of paramount importance to reduce incident CKD in the follow-up,” the authors concluded.
Chiu PF, Lin PR, Tsai CC, Hsieh YP. The impact of acute kidney injury with or without recovery on long-term kidney outcome in patients undergoing liver transplantation. Nephrol Dial Transplant. Published online January 18, 2023. doi:10.1093/ndt/gfad005