Abstract: FR-PO007
Post-Discharge Long-Term Outcomes of the Dialysis-Requiring AKI During the Perioperative Period of Liver Transplantation
Session Information
- AKI: Clinical, Outcomes, Trials - I
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Lee, Soojin, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Park, Sehoon, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Lim, Chun Soo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
- Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background
Patients undergoing liver transplantation (LT) are prone to acute kidney injury (AKI), which is known to decrease patient survival, and considerable portion of AKI patients require renal replacement therapy (RRT) during the perioperative period of LT. Nevertheless, long-term outcomes among the patients requiring RRT are not thoroughly evaluated yet.
Methods
The nationwide, population-based cohort study was conducted. Adult patients received LT in tertiary hospitals of Korea between 2006 and 2015 were considered. Patients who underwent RRT or received LT prior to the index admission were excluded. The RRT group consisted of the patients received RRT during the perioperative period of LT and the control group included the patients who did not underwent RRT.
Results
Of 8,421 patients underwent LT, 5,911 received RRT. Among the patients received RRT, 802 underwent continuous renal replacement therapy (CRRT). All-cause mortality [adjusted hazard ratio (HR) 1.52 (1.26-1.83), P<0.001] and progression to end-stage renal disease (ESRD) [adjusted HR 2.93 (2.34-3.66), P<0.001] were increased in RRT patients (Table 1). However, the risk of MACE [adjusted HR 1.17 (0.80-1.70), P=0.430] were similar between the two groups. Among the patients who received RRT, all-cause mortality [adjusted HR 2.92 (1.48-5.76), P=0.002] was worse in CRRT group, compared to intermittent renal replacement therapy (IRRT) group. ESRD progression [adjusted HR 0.36 (0.24-0.52), P<0.001] was improved with CRRT application and the risk of MACE [adjusted HR 1.11 (0.42-2.94), P=0.832] was comparable between the two groups.
Conclusion
Requirement of RRT during the perioperative period of LT had worse long-term mortality and ESRD progression compared to the patients who did not receive RRT. The risk of MACE in patients underwent RRT was comparable to the control groups.
Table 1. Prognosis of patients underwent RRT
| Model 1 | Model 2 | |||
| HR (95% CI) | p-value | adjusted HR (95% CI) | p-value | |
| Mortality | 1.14 (0.95-1.36) | 0.162 | 1.52 (1.26-1.83) | <0.001 |
| MACE | 1.03 (0.71-1.49) | 0.876 | 1.17 (0.80-1.70) | 0.430 |
| Progression to ESRD | 3.22 (2.60-3.99) | <0.001 | 2.93 (2.34-3.66) | <0.001 |
HR = hazard ratio, CI = confidential interval. Model 1 was an unadjusted simple model. Model 2 was adjusted for age, sex, comorbidities, and the etiology of liver disease.
Funding
- Commercial Support – Baxter (LSO-18-70260)