Kidney Failure after Liver Transplantation

One-third of patients with cirrhosis present kidney failure (AKI and CKD). It has multifactorial causes and a harmful effect on morbidity and mortality before and after liver transplantation. Kidney function does not improve in all patients after liver transplantation, and liver transplant recipients are at a high risk of developing chronic kidney disease. The causes of renal dysfunction can be divided into three groups: pre-operative, perioperative and post-operative factors. To date, there is no consensus on the modality to evaluate the risk of chronic kidney disease after liver transplantation, or for its prevention. In this narrative review, we describe the outcome of kidney function after liver transplantation, and the prognostic factors of chronic kidney disease in order to establish a risk categorization for each patient. Furthermore, we discuss therapeutic options to prevent kidney dysfunction in this context, and highlight the indications of combined liver–kidney transplantation.

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Peritoneal Dialysis After Liver Transplantation: A Systematic Review

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211029722 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110297

Author(s):

Jean Maxime Côté ◽

Isabelle Ethier ◽

Héloïse Cardinal ◽

Marie-Noëlle Pépin

Keyword(s):

Systematic Review ◽

Liver Transplantation ◽

Liver Transplant ◽

Kidney Failure ◽

Liver Graft ◽

Transplant Recipients ◽

Technique Survival ◽

Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

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Chronic kidney disease in liver transplantation: Evaluation of kidney function

Revista de Gastroenterología de México (English Edition) ◽

10.1016/j.rgmxen.2019.01.001 ◽

2019 ◽

Vol 84 (1) ◽

pp. 57-68

Author(s):

A. Meraz-Muñoz ◽

I. García-Juárez

Keyword(s):

Chronic Kidney Disease ◽

Liver Transplantation ◽

Kidney Disease ◽

Kidney Function

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A comparison of rates and severity of chronic kidney disease in deceased donor and living donor liver transplant recipients. Times matter.

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-2007-82 ◽

2021 ◽

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Liver Transplant ◽

Living Donor ◽

Deceased Donor ◽

Transplant Recipients ◽

Donor Liver ◽

Living Donor Liver Transplant ◽

Donor Liver Transplant ◽

Liver Transplant Recipients

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Perbedaan Kadar Hemoglobin pada Penderita Gagal Ginjal Kronik Sebelum dan Setelah Melakukan Hemodialisa

Jurnal Insan Cendekia ◽

10.35874/jic.v8i2.936 ◽

2021 ◽

Vol 8 (1) ◽

pp. 146-151

Author(s):

Virania Arvianti ◽

◽

Septian Septian ◽

Aturut Yansen ◽

◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Function ◽

Secondary Data ◽

Sampling Technique ◽

Chronic Kidney Failure ◽

Wilcoxon Test ◽

Cross Sectional ◽

Significant Difference ◽

Before And After

IntroductionAnemia is the most common occurrence in chronic kidney disease undergoing hemodialysis therapy. In the condition of chronic kidney disease, the decline in kidney function can occur slowly and chronically until the kidneys do not function at all. Hemodialysis is one of the therapies used to replaced kidney function. During hemodialysis, a decrease in hemoglobin levels often occurs, this is due to the disruption of the hormon erythropoietin. Objective:determine the differences in hemoglobin levels in patients with chronic kidney disease before and after hemodialysis at Bhayangkara TK. I Raden Said SukantoHospital. Method: The design of this research is cross sectional using secondary data and the sampling technique of this research was random sampling with a total of 133 patients. Result: The normality test was carried out first using the Kolmogorov-Smirnova test which showed the results were not normally distributed with a sig value of 0.001. the next test was the Wilcoxon test with a sig (2-tailed_ value of 0.002 with an average hemoglobin level of 8,81 g/dL before hemodialysis and 9,09 g/dL after hemodialysis. Conclusion:Based on the results of the study means that there is a significant difference in a patient with chronic kidney failure before and after hemodialysis.

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Gambaran kadar albumin serum pada pasien penyakit ginjal kronik stadium 5 non dialisis

Jurnal e-Biomedik ◽

10.35790/ebm.4.1.2016.10861 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Tiffany D. Putri ◽

Arthur E. Mongan ◽

Maya F. Memah

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Serum Albumin ◽

Kidney Function ◽

Kidney Failure ◽

Albumin Level ◽

Cross Sectional ◽

Probability Sampling ◽

Low Level ◽

Normal Albumin

Abstract: Chronic kidney disease is a pathophysiology process with diverse etiology, causing a progressive decline on kidney function, and in most cases ends with kidney failure (stage 5). The low level of albumin serum is an important predictor of the morbidity and mortality, as a low albumin level is indicating the weak immunity and vitality in kidney failure patients. This is caused by an increase on inflammation and deficiency of protein intake. The low level of albumin serum is also a major indicator which can be used to show a person’s kidney function. Hypoalbuminemia occurred if blood albumin level is less than 3,5 g/dL. Research objective: To find out the description of albumin serum level on non-dialysis chronic kidney disease patients. Research method: Cross sectional descriptive, to obtain the data of albumin serum on non-dialysis chronic kidney disease patients carried out on December 2015 – January 2016 at two hospitals, which are RSUP. Prof. Dr. R. D. Kandou Manado and Rumah Sakit Advent Manado. The research sample were the blood sample from 35 people suffering a stage five non dialysis chronic kidney disease, which determined by consecutive sampling from non-probability sampling model. Result: According to the laboratory result, from the 35 patients diagnosed with a stage five non dialysis chronic kidney disease, 16 patients are having a decrease on albumin serum (45.7%), and 19 patients are having a normal albumin level (54.4%). None of the samples are having an increase on albumin level. Conclusion: From the research it can be concluded that there are more patients with normal albumin level which is 29 people (54.5%) compared to the patients with hypoalbuminemia which is 16 people (45.7%), with male having a higher tendency of prevalence compared to female on each category of albumin serum checkup.Keywords: albumin serum, stage five chronic kidney disease, non-dialysis.Abstrak: Penyakit ginjal kronik adalah suatu proses patofisiologi dengan etiologi yang beragam, mengakibatkan penurunan fungsi ginjal yang progresif, dan pada umumnya berakhir dengan gagal ginjal (stadium 5). Kadar serum albumin rendah merupakan prediktor penting dari mordibitas dan mortalitas karena rendahnya serum albumin pada pasien gagal ginjal menggambarkan rendahnya ketahanan dan daya hidup pasien gagal ginjal terminal. Hal ini disebabkan adanya peningkatan inflamasi dan kekurangan asupan protein pada penderita. Rendahnya serum albumin juga salah satu penanda penting yang dapat digunakan untuk menunjukan fungsi ginjal dari seseorang. Dikatakan hipoalbuminemia jika kadar albumin darah kurang dari 3,5 g/dL. Tujuan Penelitian: untuk mengetahui gambaran kadar albumin serum pada pasien penyakit ginjal kronik stadium 5 non dialisis. Metode Penelitan: deskriptif cross sectional, untuk mendapatkan data tentang kadar albumin serum pada pasien penyakit ginjal kronik stadium 5 non dialisis yang dilakukan sejak Desember 2015-Januari 2016 di dua rumah sakit yaitu RSUP. Prof. Dr. R. D. Kandou Manado dan Rumah Sakit Advent Manado. Sampel penelitian adalah sampel darah dari 35 orang yang menderita penyakit ginjal kronik stadium 5 non dialisis ditentukan dengan cara non-probability sampling jenis consecutive. Hasil: Berdasarkan hasil pemeriksaan laboratorium yang dilakukan, terdapat 35 pasien yang terdiagnosis penyakit ginjal kronik stadium 5 non dialisis didapatkan bahwa 16 pasien mengalami penurunan kadar albumin serum (45.7%), 19 orang memiliki kadar albumin dalam batas normal (54.3%) dan tidak terdapat peningkatan kadar albumin sama sekali pada pasien yang dilakukan penelitian. Simpulan: Dari hasil penelitian dapat disimpulkan bahwa kadar albumin serum pada pasien dengan kadar albumin yang masih dalam batas normal yaitu sebanyak 19 orang (54.3%) lebih banyak dibandingkan dengan hipoalbuminemia yaitu sebanyak 16 orang (45.7%) dimana jenis kelamin laki-laki cenderung lebih tinggi prevalensinya dibandingkan dengan perempuan pada tiap kategori hasil pemeriksaan kadar albumin serum.Kata kunci: albumin serum, penyakit ginjal kronik stadium 5, non dialisis.

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Effect of cyclosporin and tacrolimus on kidney function in liver recipients

Research Results in Pharmacology ◽

10.3897/rrpharmacology.4.29502 ◽

2018 ◽

Vol 4 (3) ◽

pp. 37-42

Author(s):

Elena Kosmacheva ◽

Anna Babich

Keyword(s):

Chronic Kidney Disease ◽

Liver Transplantation ◽

Renal Function ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Glomerular Filtration ◽

Kidney Function ◽

Filtration Rate ◽

Calcineurin Inhibitors

Introduction. Chronic renal failure is a significant issue regarding treatment of patients after liver transplantation. One of the factors determining the impaired renal function after liver transplantation is a long-term immunosuppressive therapy based on calcineurin inhibitors. The objective of the study was to evaluate the dynamics of renal function, depending on the use of various calcineurin inhibitors in the long-term postoperative period in liver recipients in real clinical practice. Materials and methods. A retrospective analysis of the renal function in patients operated in the State Public Health Budget Institution “Scientific Research Institute – S.V. Ochapovsky Regional Clinic Hospital № 1”, Krasnodar Region, was carried out. This article describes dynamics of creatinine level and glomerular filtration rate (GFR) in patients before liver transplant, as well as 6 months, 1, 2 and 3 years after surgery. GFR was calculated using the CKD-EPI formula (Chronic Kidney Disease Epidemiology Collaboration). Statistical processing of the results was carried out using the Statistica 10 software package. Results and discussion. Before transplantation, the level of creatinine in the blood plasma was 82.9±19.8 mmol/l, 6 months later a20.4% increase in creatinine was registered (p=0.004), 12, 24 and 36 months later – it increased by 24.8% (p=0.00001), 24.4% (p=0.0004), and 26.0% (p=0.0005), respectively. Both cyclosporine and tacrolimus caused an increase in the level of creatinine. Baseline GFR was 83.4±25.9, the reduction in GFR occurred in comparison with the baseline by 14.2% (p=0.0005), 18.8% (p=0.00001), 20.2% (p=0.00003), 22.6% % (p=0.00006) 6, 12, 24 and 36 months later, respectively. The degree of the decrease in GFR against the background of tacrolimus therapy did not differ significantly from that in case of cyclosporine. Verification of chronic kidney disease and the administration of statins were recorded in isolated cases. Conclusions. In liver recipients, the level of creatinine rises and GFR decreases. Reduction of kidney function occurs against the background of both inhibitors of calcineurin, in connection with which it is necessary to increase the doctors’ alertness for early detection of a decrease in glomerular filtration rate with further verification of chronic kidney disease.

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Description of Serum Urea and Creatinine Levels Pre Hemodialysis and Post Hemodialysis at Royal Prima Hospital in Chronic Kidney Disease

Archives of The Medicine and Case Reports ◽

10.37275/amcr.v2i2.19 ◽

2021 ◽

Vol 2 (2) ◽

pp. 118-123

Author(s):

Raymond Nazimuddin Putra ◽

Valentine Athania Br Perangin-angin ◽

Sahna Ferdinand ◽

Erny Tandanu

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Serum Level ◽

Creatinine Level ◽

Kidney Function ◽

Kidney Failure ◽

Chronic Kidney Failure ◽

Serum Urea ◽

Urea Level ◽

Gradual Loss

Chronic Kidney Failure describes as the gradual loss of kidney functionand it is irreversible, to replace the loss of kidney function a therapy tokidney function is needed, which is hemodialysis. The objective of thisresearch is to know the levels of ureu and creatinine serum for prehemodialysis and post hemodialysis at RSU Royal Prima Medan. Themethods that are being used for this research is descriptive with 54 patientsas samples. The results of this research is loss of urea and creatinine serumlevel, with the average of urea level for pre hemodialysis is 128.11 mg/dL,and the average of urea level for post hemodialysis is 43.26 mg/dL with1,8% patient with low urea level, 50% with normal urea level, and 48.2%with high urea level. The average of creatine level for pre hemodialysis is11.56 mg/dL, and the average of creatine levels is 4.3 mg/dL, with all of thepatient still have a high creatinine levels. The conclusion is there is drop forboth urea and creatinen serum level, but the urea level for half of the patientdid not go down to normal, and for the creatinine level there is none of thepatient creatinine level that go down to normal.

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