Abstract: FR-PO1057
Kidney Function Decline in Lung Transplant Recipients
Session Information
- Transplantation: Clinical - Pharmacology and Nonkidney Solid Organ Transplants
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Schneider, Ethan R, University of Kentucky College of Medicine, Lexington, Kentucky, United States
- Rao, Madhumathi, University of Kentucky College of Medicine, Lexington, Kentucky, United States
Background
Lung transplant (LT) recipients are at risk of kidney function decline from calcineurin inhibitors and other complications. Longitudinal data on kidney function trajectories and associated risk factors are limited.
Methods
This retrospective study of 50 consecutive adult LT patients aimed to characterize 2-year kidney function trends and risk factors for decline. Creatinine values were recorded pre-LT, at one-month post-LT (25–35 days), at 2-years post-LT (21–27 months), and monthly. The slope of creatinine progression over time was calculated for each patient using linear regression. Kidney function decline was analyzed in relation to age, sex, nephrology consult, and hospitalization frequency.
Results
Mean age at LT was 57 ± 9.9 years; 50% were male. Mean creatinine (mg/dL) at pre-LT of 0.7 ± 0.2 increased at one-month post-LT to 0.8 ± 0.3 (n=50, p=<0.01). Mean number of hospitalizations within 2 years post-LT was 3.0 ± 2.9, and 31% had nephrology consults.
When slopes of creatinine progression were divided at the median, patients with steeper slopes were more likely to be female (64% vs. 36%, p=0.05) and more likely to have formal nephrology consultation (75% vs. 25%, p=0.03). There was no difference in age or hospitalization frequency.
The 2-year analysis excluded patients who did not survive 2 years (N=5) or had LT <2 years ago (n=9). Pre-LT creatinine increased from 0.7 ± 0.2 to 1.1 ± 0.3 at 2 years (N=36 p<0.01). Patients with 2-year creatinine above the median had significantly steeper slopes of creatinine progression than those below the median (p < 0.01), although pre-LT creatinine did not differ (p=0.71).
Conclusion
In this cohort of LT recipients, kidney function declined significantly over two years, with the decline detectable by the first month post-LT. Female patients had steeper rates of decline. Higher 2-year creatinine was associated with steeper creatinine slopes, but not pre-LT creatinine, suggesting that post-LT factors play a more important role in decline. Patients with steeper slopes of creatinine progression are a distinct high-risk group for kidney function decline. Our findings support early identification of high-risk patients, early nephrology referral, and reno-protective measures where appropriate.