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Kidney Week

Abstract: TH-PO516

Predictors for the Development of CKD Stage 2 or Higher in Repeat Pediatric Heart Transplant Recipients

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Author

  • Chan, Melvin, University of Colorado, Denver, Colorado, United States
Background

There is little data on the risk factors for developing chronic kidney disease (CKD) in repeat pediatric heart transplant recipients.

Methods

All repeat heart transplants (RT) at our center from 1995-2021 were reviewed. Renal function was determined by estimated glomerular filtration rate (eGFR) derived from CKiD U25 calculator using creatinine at each hospital and clinic visit. The stages of acute kidney injury (AKI) were in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Independent samples t-test was conducted on the development of CKD stage 2 or higher and the following variables: pre-transplant eGFR; post-transplant eGFR at 1-3 months; ages at first heart transplant (FT) and RT; time between transplants; gestational age; weight category prior to transplant; and number of AKIs between FT and RT. Multivariate logistical regression was performed for significant variables.

Results

A total of 43 RT were included in this cohort, with a majority being Caucasian and mean age of 14 years old. Median follow-up time was 3 years. Univariate analysis showed significant associations between development of CKD stage 2 or higher and the following variables: pre-transplant eGFR, post-transplant eGFR at 1-3 months, the number of stage 2 and 3 AKIs between FT and RT. Multivariate logistic regression showed that post-transplant eGFR at 1-3 months (OR 0.92) and number of stage 2 and 3 AKIs (OR 21.5) remained significant, with an AUC of 0.91, sensitivity of 0.97, and specificity of 0.60.

Conclusion

Our preliminary data shows the post-transplant eGFR at 1-3 months and number of stage 2 and 3 AKIs are predictors for the development of chronic kidney disease stage 2 or higher. More research is needed to look at predictors for development of advanced chronic kidney disease to inform transplant teams when a repeat heart transplant or a dual heart and kidney transplant can be done.