Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation

CKJ: Clinical Kidney Journal - Tập 13 Số 5 - Trang 828-833 - 2020
Nans Florens1,2, Laurence Dubourg2, Laurent Bitker2, Emilie Kalbacher2, F. Philit3,4, Jean‐Marc Rolain3,4, François Parant3, Fitsum Guebre‐Egziabher1,2, Laurent Juillard1,2, Sandrine Lemoine1,2
1CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition (Faculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex - France)
2Service de néphrologie, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, France - Service de néphrologie, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, France (France)
3HCL - Hospices Civils de Lyon (3 Quai des Célestins 69002 Lyon - France)
4IVPC - Infections Virales et Pathologie Comparée - UMR 754 (50 Avenue Tony Garnier 69366 Lyon Cedex 07 - France)

Tóm tắt

Abstract Background Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD. Methods LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Results During the study period, 111 patients were lung transplant candidates, of which 91 had a pre-transplantation mGFR, and 29 had a mGFR at 1 year after LT. Six patients underwent maintenance haemodialysis after transplantation. Mean mGFR was 106 mL/min/1.73 m2 before LT and 58 mL/min/1.73 m2 1 year after LT (P < 0.05) with a mean loss of 48 mL/min/1.73 m2 per patient. The risk of developing Stage ≥3 CKD after LT was higher in patients with lower pre-LT mGFR (odds ratio for each 1 mL/min/1.73 m2 increase: 0.94, 95% confidence interval 0.88–0.99). Receiver operator characteristics curves for the sensitivity and specificity of eGFR and mGFR for the prediction of CKD Stage ≥3 after LT found that pre-LT mGFR of 101 mL/min/1.73 m2 and pre-LT eGFR of 124 mL/min/1.73 m2 were the optimal thresholds for predicting Stage ≥3 CKD after LT. Conclusion The present study underlines the value of mGFR in the pre-LT stage and found major renal function loss after LT, and consequently two-thirds of patients have Stage ≥3 CKD at 1 year. All patients with a pre-LT mGFR <90 mL/min/1.73 m2 warrant particular attention.

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Thông tin xuất bản

CKJ: Clinical Kidney Journal

Tập 13 Số 5

828-833

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