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Kidney Week

Abstract: PO1958

Predictors of Renal Function in Pediatric Liver Transplant Recipients

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Elchaki, Rim, University of California Los Angeles, Los Angeles, California, United States
  • Wilhalme, Holly, University of California Los Angeles, Los Angeles, California, United States
  • Venick, Robert S., University of California Los Angeles, Los Angeles, California, United States
  • Laster, Marciana, University of California Los Angeles, Los Angeles, California, United States
Background

Impaired kidney function is a well-recognized complication following liver transplant (LT). In adult LT recipients, the cumulative incidence of renal insufficiency is as high as 10% in 10 years. The burden of kidney dysfunction is thought to be higher in pediatric LT recipients due to longer exposure to nephrotoxic agents & longer lifespan. The aim of this study is to identify predictors of renal function decline in pediatric LT recipients.

Methods

This is a retrospective study of pediatric LT recipients between June 2008 to November 2014. Clinical and biochemical characteristics and eGFR were obtained at baseline, 6, 12, 24, and 60 months. CKD was defined as an eGFR <90 ml/min/1.73 m2 for a least 3 months post-LT. A Multivariable Cox Proportional Hazards model was created to determine predictors of progression to CKD post-LT.

Results

Table 1 shows the baseline characteristics of patients with CKD post-LT compared to those who did not. In bivariate analysis, age, African American race, tumor diagnosis, baseline eGFR, pre-transplant HD and AKI were associated with progression to CKD (Figure 1). In multivariable analysis, factors associated with increased risk of progression to CKD included: older age at LT (HR 1.012, p<0.001), tumor diagnosis (HR 3.602, p=0.0126) and lower baseline eGFR (HR 0.986, p=0.0014).

Conclusion

In our study we found that risk factors for CKD include: older age at the time of LT, lower baseline eGFR and tumor diagnosis. Further studies are underway to evaluate the role of Tacrolimus in the progression to CKD post LT

Funding

  • Other NIH Support