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Kidney Week

Abstract: FR-PO1175

Change in Kidney Function for Three Years in Pediatric Kidney Transplant Recipients

Session Information

  • Pediatric Nephrology - I
    October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Hashimoto, Junya, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
  • Hamasaki, Yuko, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
  • Takahashi, Yusuke, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
  • Muramatsu, Masaki, Toho University Faculty of Medicine, Ohta-ku, ToKyo, Japan
  • Kawamura, Takeshi, Toho University Faculty of Medicine, Ohta-ku, ToKyo, Japan
  • Sakai, Ken, Toho University Faculty of Medicine, Ohta-ku, ToKyo, Japan
  • Shishido, Seiichiro, Toho University Faculty of Medicine, Ota-ku, Tokyo, Japan
Background

Few data show the changes in graft function after kidney transplantation (KTx) in children. We retrospectively investigated the change in kidney function for three years in pediatric kidney transplant recipients based on estimated glomerular filtration rate (eGFR).

Methods

We enrolled the recipients aged 2-15 years who underwent living-donor KTx at our institution between 2009 and 2017. We excluded the recipients with primary non-function (n=2), low muscle bulk due to being bedridden (n=2). In 56 recipients, changes in eGFR were evaluated for three years after KTx. eGFR was calculated by the creatinine-based equation for Japanese children and adolescents aged 2-18 years.

Results

During follow-up, patient and graft survival rates were 100%. Twenty-five recipients (44.6%) experienced acute rejection with treatment. The mean age of recipients and donors were 8.1±4.0, and 41.1±7.8 years old. Congenital anomalies of the kidney and urinary tract (n=34) was the most common disease for end stage kidney disease. The mean eGFR (ml/min./1.73m2) at 1, 4, 12, 24, and 36 months (M) after KTx were 85.1±18.6, 73.4±16.6, 67.0±15.7, 65.3±15.0, 66.4±18.9, respectively. eGFR at 1 and 12 M post-transplant showed significant difference (p<0.0001, paired t-test). eGFR became stable at 12 M post-transplant and thereafter. In 17 recipients (30.4%), eGFR at 36 M was below 60. On multivariable logistic regression analyses, eGFR <60 at 1 M after KTx was the impact factor related to eGFR <60 at 36 M.

Conclusion

Approximately 70% of the recipients showed kidney function equivalent to over CKD stage 3 at three years after KTx, though eGFR declined within the first year post-transplant. To preserve long-term kidney graft function, the recipients with low eGFR at one month post-transplant need careful management.

Fig. Change of the mean eGFR of 56 pediatric recipients after living-donor KTx.