Chronic Kidney Disease in Renal Transplant Recipients
| Autor: | Joaquín Ortuño, José L. Teruel, E.J. Ocaña, Juan José Villafruela, J. Pascual, F.J. Burgos, M Fernández, Roberto Marcén, Maria Teresa Tenorio |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Anemia medicine.medical_treatment Urology Renal function urologic and male genital diseases Body Mass Index Postoperative Complications Predictive Value of Tests Cadaver medicine Humans Dialysis Retrospective Studies Transplantation Kidney urogenital system business.industry Graft Survival Immunosuppression medicine.disease Kidney Transplantation Tissue Donors female genital diseases and pregnancy complications Surgery medicine.anatomical_structure Predictive value of tests Chronic Disease Female Kidney Diseases business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Transplantation Proceedings. 37:3718-3720 |
| ISSN: | 0041-1345 |
| Popis: | The aim of the present study was to investigate the utility in renal transplant patients of the guidelines for the diagnosis and classification of chronic kidney disease (CKD) based on the estimated glomerular filtration rate (GFR) elaborated by the Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation.Four hundred forty-seven cadaveric kidney transplants performed between 1980 and 1994 with graft function at 12 months were included in the study. The GFR was calculated according to the MDRD equation.The mean GFR at 12 months was 54.5 +/- 20.3 mL/min/1.73 m(2): 23 patients (5.1%) had a GFRor =90 mL/min/1.73 m(2); 136 patients (30.6%), 60-89; 246 (54.7%), 30-59; 35 patients (7.8%), 15-29; and 7 patients (1.6%), GFR15. Similar distribution of CKD stages was observed at 5 and 10 years. Unadjusted graft survival at 10 years was better among patients with a higher GFR at 12 months: 87% in patients with GFR90 mL/min/1.73 m(2); 83% of GFR 60-89 mL/min/1.73 m(2); 63%, GFR 30-59 mL/min/1.73 m(2); and 23%, GFR30 mL/min/1.73 m(2) (P.001). The association between GFR and graft survival persisted when adjusted by the age and gender of the recipients and donors, time on dialysis, body mass index, immunosuppression, delayed graft function, rejection, and HLA mismatches. The prevalence of complications, such as anemia, hypertension, dyslipidemias, and number of drugs increased as GFR declined.More than 60% of recipients presented chronic kidney disease. GFR was a predictive factor for graft survival at 10 years. The classification of renal transplant patients by CKD stages may help to identify patients with increased risk of graft loss and also to design strategies to improve outcomes. |
| Databáze: | OpenAIRE |
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