Chronic Kidney Disease After Liver Transplantation.
| Autor: | Cabeza Rivera FH; Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL., Concepcion BP; Department of Medicine, Section of Nephrology, University of Chicago, Chicago, IL. Electronic address: beacon@uchicago.edu., Levea SL; Division of Nephrology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX. |
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| Jazyk: | angličtina |
| Zdroj: | Advances in kidney disease and health [Adv Kidney Dis Health] 2023 Jul; Vol. 30 (4), pp. 368-377. |
| DOI: | 10.1053/j.akdh.2023.07.004 |
| Abstrakt: | Chronic kidney disease among liver transplant recipients is common and associated with an increased mortality risk. Several risk factors and causes for the development of chronic kidney disease have been identified. They can be divided into perioperative factors, such as unresolved acute kidney injury; donor-related factors, such as the use of extended criteria liver allografts; and recipient-related factors, such as the use of calcineurin inhibitors and the presence of metabolic syndrome, diabetes, and obesity. There is a bimodal progression, more prominent during the initial post-transplant months, followed by a gradual but progressive decline over the subsequent years. Management strategies to prevent and treat chronic kidney disease in the general population can be reasonably applied to the liver transplant population and include addressing comorbidities such as hypertension and diabetes. Strategies to minimize or withdraw calcineurin inhibitors from the immunosuppressive regimen can slow progression of kidney dysfunction. Patients with advanced chronic kidney disease should be considered for kidney transplantation due to its survival advantage. Allocation policy in the United States confers safety-net allocation priority for liver transplant recipients who develop advanced chronic kidney disease within the first year of liver transplantation. (Copyright © 2023 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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