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Chronic kidney disease in children following lung and heart-lung transplantation

Marks, SD; Benden, C; Kansra, S; Shaw, NL; Aurora, P; Elliott, MJ; Ridout, DA; (2009) Chronic kidney disease in children following lung and heart-lung transplantation. Pediatric Transplantation , 13 (1) 104 - 110. 10.1111/j.1399-3046.2008.01060.x.

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Abstract

CKD is a major co-morbidity in pediatric lung transplant recipients. We report the prevalence of renal impairment post-lung transplant at a single center, using a modified, age-adjusted eGFR for the best approximation of true GFR, and investigated associations and possible predictors of decline in renal function post-transplant. Renal function was assessed by eGFR pre-transplant, three and 12 months post-transplant, and at last follow-up. Decline in renal function was analyzed as percentage fall in eGFR in two phases (0-3 and 3-12). Furthermore, we investigated impact of gender, age, pre-transplant diagnosis and renal function, transplant type, early post-transplant dialysis, and tacrolimus trough levels on decline in eGFR using multivariate analysis. Over a five-yr period, 30 transplants were performed. Mean eGFR pretransplant was 117 mL/min/1.73 m (s.d. 35) with mean decline in eGFR during the first three months post-transplant of 33% (s.d. 31, p < 0.001). Thereafter, mean decline in eGFR was 8% (s.d. 18, p = 0.02). None of the factors assessed were significantly associated with decline in eGFR post-transplant. In conclusion, many children have decline in renal function following lung transplantation, particularly early post-transplant. Unlike in adults, we were unable to detect any predictors of renal impairment in pediatric lung transplant recipients. © 2008 Wiley Periodicals, Inc.

Type: Article
Title: Chronic kidney disease in children following lung and heart-lung transplantation
DOI: 10.1111/j.1399-3046.2008.01060.x
UCL classification: UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health
URI: http://discovery.ucl.ac.uk/id/eprint/50695
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