Autori: A. Cappoli1,2, F. Tinti1, F. Maellaro1,2, K. Korreshi1,2, I. Umbro1, E. Poli 1, S. Ginanni Corradini1, P. B. Berloco4, M. Rossi4, S. Lai1.2, S. Mazzaferro2,3, A.P. Mitterhofer1,2
Affiliazioni: Dipartimento di Medicina Clinica1, Scuola di Specializzazione in Nefrologia e UOC di Nefrologia2, Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche3, Dipartimento di Chirurgia Generale e dei Trapianti4, Policlinico Umberto I, Sapienza Università di Roma.
INTRODUCTION: Acute kidney injury (AKI) post-liver transplantation (OLT) is as an important risk factor for increased mortality of liver transplant patients. The occurrence of AKI recognizes multiple risk factors, related to pre-operative patient disease, intraoperative events and post-operative factors. Aim of the study was to evaluate the incidence of post-OLT AKI, its relationship with survival and the related risk factors.
MATHERIALS AND METHODS: From a cohort of 150 consecutive liver transplant recipients, we analyzed the data of 145 patients (117 male and 28 female); the occurrence of AKI post-OLT was evaluated according to KDIGO guidelines. Chronic kidney disease (CKD) was defined as a reduction of the eGFR less than 60 mL/min/1.73 m2 longer than 3 months.
RESULTS: 83 patients (57.2%) developed AKI; of them 61 patients (42.1%) presented AKI stage 1, 12 patients (8.3%) AKI stage 2 and 10 (6.9%) patients AKI stage 3. Based on this classification, patients were divided in 2 groups: patients with No-AKI & AKI stage 1 (Group 1) and patients with AKI stages 2 & 3 (Group 2). A higher number of female patients were represented in the group 2 who developed AKI stages 2 & 3 compared to group 1 (40.9% and 15.4%, respectively). On the univariate analysis female gender, pre-OLT creatinine, MELD score, and the presence of eGFR>120 mL/min/1.73m2 were significantly associated with the occurrence of AKI stages 2 & 3. On the multivariable analysis, female gender and the eGFR>120 were the significant predictive factors for development of AKI stages 2 & 3.
CONCLUSION: female gender resulted as independent predictor of AKI, which is associated with the development of CKD in liver transplantation with reduced patient survival.