Association of pretransplant kidney function with outcomes after lung transplantation

Purpose There is a lack of data regarding the independent association of pretransplant kidney function with early and late outcomes among lung transplant ( LT ) recipients. Methods We queried the United Network for Organ Sharing database for adult patients (≥18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate ( GFR ) was estimated using the modification of diet in renal disease ( MDRD ) and the Chronic kidney disease epidemiology collaboration ( CKD ‐ EPI ) equations. The study population was split into four groups (>90, 60‐90, 45‐59.9, and <45 mL/min/1.73 m 2 ) based on the estimated GFR at the time of listing. Results Overall, there was a good correlation between the GFR estimated from the two equations (n=17884, Pearson r =.816, P <.001). There was a consistent and independent association of worse early and late outcomes with declining GFR throughout the spectrum including those above 60 mL/min/1.73 m 2 ( P <.001 for overall comparisons). Although GFR <45 mL/min/1.73 m 2 was associated with worse early and late survival, patients with GFR 45‐59.9 mL/min/1.73 m 2 do not appear to have survival advantage beyond 3 years post‐transplant. Conclusion There is a good correlation between GFR estimated using MDRD and CKD ‐ EPI equations among patients being considered for LT . Early and late outcomes after LT worsen in a linear fashion with progressively lower pretransplant GFR .