Premium
Fading renal hyperfiltration in children following liver transplantation
Author(s) -
Schell Matthias,
Lachaux Alain,
HadjAïssa Aoumeur,
Dubourg Laurence,
Mahmoud Ayman,
Boillot Olivier,
Saïd MarieHélène,
Cochat Pierre
Publication year - 2001
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1034/j.1399-3046.2001.00034.x
Subject(s) - medicine , renal function , nephrotoxicity , liver transplantation , urology , inulin , glomerular hyperfiltration , transplantation , trough level , kidney , tacrolimus , biochemistry , chemistry , diabetic nephropathy
Abstract: In a prospective longitudinal study, we investigated the renal function (RF) of 23 children before and after orthotopic liver transplantation (OLT). The aim was to assess both the outcome of pretransplant hyperfiltration and the clinical nephrotoxic effects of cyclosporin A (CsA); children with decreased RF prior to OLT were therefore excluded. The RF study of the 13 remaining patients included glomerular filtration rate (GFR) and effective renal plasma flow (RPF) measured by inulin (Cin: mL/min/1.73 m 2 ) and para‐amino hippurate (Cpah: mL/min/1.73 m 2 ) clearances, respectively. Hyperfiltration prior to OLT was observed in six children, i.e. Cin > 170 [range 172–230] and Cpah > 800 [808–1133]. A significant decrease in RF was noted as soon as 6 months after OLT: Cin (mean±SD) = 107 ± 23 vs. 158 ± 46 (p<0.003); Cpah = 583 ± 119 vs. 791 ± 243 (p<0.004). This was due to loss of hyperfiltration in the six children, as there was no significant difference in RF before and 6 months after OLT in the other seven children. With a 36‐month follow‐up, there was no correlation between CsA trough blood level and RF. In conclusion, following OLT, RF underwent early changes owing to loss of prior hyperfiltration in children without impaired RF before OLT. In addition, no evidence of CsA nephrotoxicity was found and RF remained stable during follow‐up.