scholarly journals Long-Term Outcomes and Risk Factors of Renal Failure Requiring Dialysis after Heart Transplantation: A Nationwide Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2455 ◽  
Author(s):  
Tsai-Jung Wang ◽  
Ching-Heng Lin ◽  
Hao-Ji Wei ◽  
Ming-Ju Wu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Heart Transplantation ◽  
Renal Dysfunction ◽  
Heart Transplant ◽  
Kidney Injury ◽  
Dialysis Patients ◽  
Term Survival

Acute kidney injury and renal failure are common after heart transplantation. We retrospectively reviewed a national cohort and identified 1129 heart transplant patients. Patients receiving renal replacement therapy after heart transplantation were grouped into the dialysis cohort. The long-term survival and risk factors of dialysis were investigated. Patients who had undergone dialysis were stratified to early or late dialysis for subgroup analysis. The mean follow-up was five years, the incidence of dialysis was 28.4% (21% early dialysis and 7.4% late dialysis). The dialysis cohort had higher overall mortality compared with the non-dialysis cohort. The hazard ratios of mortality in patients with dialysis were 3.44 (95% confidence interval (CI), 2.73–4.33) for all dialysis patients, 3.58 (95% CI, 2.74–4.67) for early dialysis patients, and 3.27 (95% CI, 2.44–4.36; all p < 0.001) for late dialysis patients. Patients with diabetes mellitus, chronic kidney disease, acute kidney injury, and coronary artery disease were at higher risk of renal failure requiring dialysis. Cardiomyopathy, hepatitis B virus infection, and hyperlipidemia treated with statins were associated with a lower risk of renal dysfunction requiring early dialysis. The use of Sirolimus and Mycophenolate mofetil was associated with a lower incidence of late dialysis. Renal dysfunction requiring dialysis after heart transplantation is common in Taiwan. Early and late dialysis were both associated with an increased risk of mortality in heart transplant recipients.

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival ◽  
One Year

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center, assess risk factors for one-year mortality, and predict short- and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 to Jan 2020 analyzed the pre-, intra-, and postoperative characteristics of 87 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Twenty-six (36.1%) patients developed AKI. The one-year mortality rates in HTx patients with and without AKI were 26.92% and 10.87%, respectively (P > 0.05). Recipients who required renal replacement therapy (RRT) had a one-year mortality rate of 53.85% compared to 10.87% in those without AKI or RRT (P = 0.003). A long cardiopulmonary bypass (CPB) time (OR: 1.622, 95% CI: 1.014 to 2.595, P = 0.044) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.566, 95% CI: 0.344 to 0.930, P = 0.025) was negatively correlated with AKI. AKI requiring RRT (HR, 6.402; 95% CI, 2.014–20.355, P = 0.002) was a risk factor for death. Overall survival in patients without AKI at 1, 3, and 5 years was higher than that in patients with AKI (P > 0.05). Conclusions AKI is common after HTx and adversely impacts early mortality. A long CPB time and low intraoperative urine volume maybe associated with the occurrence of AKI. AKI requiring RRT could contribute powerful prognostic information to predict short-term survival.

scholarly journals Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yi-Yao Jiang ◽  
Xiang-Rong Kong ◽  
Fen-Long Xue ◽  
Hong-Lei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (P < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P < 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, P = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P = 0.096). Conclusions AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong ◽  
Fenlong Xue ◽  
Honglei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives: This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods: This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results: : Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21% and 6.45%, respectively (P<0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P<0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P=0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P=0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418-53.267, P=0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P=0.096).Conclusions: AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

scholarly journals MO422ACUTE KIDNEY INJURY AFTER HEART TRANSPLANTATION , INCIDENCE AND PREDICTIVE FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nooshin Dalili
Keyword(s):  
Risk Factors ◽  
Heart Transplantation ◽  
Renal Dysfunction ◽  
Heart Transplant ◽  
Univariate Analysis ◽  
Time History ◽  
Kidney Injury ◽  
Liver Function Tests ◽  
Ischemic Time ◽  
Post Transplant

Abstract Background and Aims Abruptly decreased kidney function is one of the common scenarios after heart transplantation and the risk factors for renal dysfunction in this population can be various. The purpose of the present study was to determine the incidence and predictors for renal dysfunction among 126 patients in early postoperative heart transplantation period between January 2015 and November 2019. Method The study was conducted at the department of cardio-thoracic intensive care unit of an affiliated teaching hospital. 126 patients had cardiac transplantation surgery during four years. Information from these patients collected on a daily basis using standardized forms. Results Out of 126 heart transplant recipients 58.7 % (n=74) developed AKI and 10% (n=13) required renal replacement therapy after transplant. After performing univariate analysis, predictors of AKI were: age, duration of anesthesia, cold ischemia time, Voluven (Starch) dose, pre-operative BUN, creatinine and serum albumin, level of liver function tests, and Hemoglubin at three-days post-transplant and urine output of less than 200ml/ hour at six-hours post-transplant. Conclusion The findings of our study suggest that longer duration of graft ischemic time, history of previous cardiac operation and transfusion of more than four blood units can independently predict the chance of developing AKI following heart transplant. Therapies, which target these modifiable risk factors, may offer protection against this complication.

scholarly journals Risk Factors for Long-Term Mortality and Progressive Chronic Kidney Disease Associated With Acute Kidney Injury After Cardiac Surgery

Medicine ◽  
2015 ◽  
Vol 94 (45) ◽  
pp. e2025 ◽  
Author(s):  
Jia-Rui Xu ◽  
Jia-Ming Zhu ◽  
Jun Jiang ◽  
Xiao-Qiang Ding ◽  
Yi Fang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Long Term Mortality

scholarly journals The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans

2010 ◽  
Vol 78 (9) ◽  
pp. 926-933 ◽  
Author(s):  
Steven G. Coca ◽  
Joseph T. King ◽  
Ronnie A. Rosenthal ◽  
Melissa F. Perkal ◽  
Chirag R. Parikh
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Additional Parameter ◽  
Term Survival ◽  
Long Term Survival

Acute kidney injury following coronary angiography: a nationwide study of incidence, risk factors and long-term outcomes

2018 ◽  
Vol 31 (5) ◽  
pp. 721-730 ◽  
Author(s):  
Dadi Helgason ◽  
Thorir E. Long ◽  
Solveig Helgadottir ◽  
Runolfur Palsson ◽  
Gisli H. Sigurdsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Kidney Injury ◽  
Long Term Outcomes ◽  
Nationwide Study ◽  
Incidence Risk

1370: EPIDEMIOLOGY AND LONG-TERM SURVIVAL FOR DIFFERENT TRAJECTORIES OF ACUTE KIDNEY INJURY AFTER SEPSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 668-668
Author(s):  
Tezcan Ozrazgat Baslanti ◽  
Zhongkai Wang ◽  
Gabriella Ghita ◽  
Larysa Sautina ◽  
Rajesh Mohandas ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Term Survival ◽  
Long Term Survival

scholarly journals The Risk of Acute Kidney Injury and Its Impact on 30-Day and Long-Term Mortality after Transcatheter Aortic Valve Implantation

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Katrin Gebauer ◽  
Gerhard-Paul Diller ◽  
Gerrit Kaleschke ◽  
Gregor Kerckhoff ◽  
Nasser Malyar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
High Risk ◽  
Aortic Valve ◽  
Kidney Injury ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
Long Term Mortality

Background. Transcatheter aortic valve implantation (TAVI) is widely used in high risk patients (pts) with aortic stenosis. Underlying chronic kidney disease implicates a high risk of postprocedural acute kidney injury (AKI). We analyzed its occurrence, impact on hospital stay, and mortality.Methods. 150 consecutive pts underwent TAVI in our institution (mean age81 ± 7years; logistic EuroSCORE24 ± 15%). AKI definition was a creatinine rise of26.5 μmol/L or more within 48 hours postprocedural. Ten patients on chronic hemodialysis were excluded.Results. AKI occurred in 28 pts (20%). Baseline creatinine was higher in AKI pts (126.4 ± 59.2 μmol/L versus 108.7 ± 45.1 μmol/L,P=0.09). Contrast media use was distributed evenly. Both, 30-day mortality (29% versus 7%,P<0.0001) and long-term mortality (43% versus 18%,P<0.0001) were higher; hospital stay was longer in AKI pts (20 ± 12 versus 15 ± 10 days,P=0.03). Predicted renal failure calculated STS Score was similar (8.0 ± 5.0% [AKI] versus 7.1 ± 4.0% [non-AKI],P=0.32) and estimated lower renal failure rates than observed.Conclusion. AKI remains a frequent complication with increased mortality in TAVI pts. Careful identification of risk factors and development of more suitable risk scores are essential.

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