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Kidney Week

Abstract: FR-PO451

Prognostic Potential of Calcitriol in the Patients Requiring Postoperative Continuous Renal Replacement Therapy After Liver Transplantation

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kim, Haksoo, Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Seong hoon, Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
  • Park, Hyang-Sook, Department of Nursing, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Eun kyoung, Dankook University College of Medicine, Cheonan-si, Korea (the Republic of)
  • Chang, Jai won, Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
Background

The mortality of the patients with End-Stage Liver Disease and renal dysfunction is high. It is important to know and correct the predicting risk factors of mortality in the patients requiring continuous renal replacement therapy (CRRT) after liver transplantation (LT). lmmunomodulatory and anti-inflammatory effects of calcitriol, produced by liver and kidney, improved survival rate in the animal experiment underwent solid organ transplantation. We investigated whether lower calcitriol level is associated with the mortality in in the patients requiring CRRT after LT.

Methods

We conducted a retrospective study consisted of 65 patients requiring CRRT after LT. Their demographic data and biochemistry parameters were obtained at the initiation of CRRT by reviewing electronic medical records. The deficiency of calcitriol was defined as its plasma level < 10 pg/ml. Primary end point was 180-day mortality from the initiation of CRRT after LT.

Results

The subjects were divided into calcitriol deficient group (CDG, n=36) and calcitriol non-deficient group (CNDG, n=29). There were no significant differences in demographics between two groups. Compared with CDG, hematocrit (26.3 ± 2.3 vs. 20.5 ± 5.1 (%), p=0.045) and 25(OH)D3 (7.2 ± 2.8 vs. 2.8 ± 1.2 (ng/ml), p=0.011) were higher in CNDG at the initiation of CRRT. In contrast, 180-day mortality in CDG (30.6%, 11/36) was higher than that of CNDG (3.4%, 1/29, p=0.005). By Cox regression analysis, calcitriol deficiency (OR 25.9, 95% CI 2.72-246.9, p=0.005) and Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) classification (OR 0.4, 95% CI 0.16-0.99, p=0.046) was risk factor of mortality after adjusting Model for End-Stage Liver Disease (MELD) score, RIFLE and 25(OH)D3.

Conclusion

Calcitriol deficiency is associated independent risk factor with the mortality in the patients requiring CRRT after LT. In the future, randomized interventional trial is necessary to confirm whether calcitriol is a correctable risk factor to improve the survival in them.