Renal function status in liver transplant patients in the first month post‐transplant is associated with progressive chronic kidney disease

Aim Renal dysfunction is a common complication of liver transplantation ( LT ), related to hepatorenal syndrome with end‐stage liver disease or calcineurin‐inhibitor nephrotoxicity. Chronic kidney disease ( CKD ) is also a common problem in long‐term survivors post‐ LT . This study was done to investigate the association between renal functional status soon after LT and the development of CKD . Methods We retrospectively evaluated 63 patients who were aged 18 years or older, and underwent LT at T ohoku U niversity H ospital. The estimated glomerular filtration rate (e GFR ) was calculated by the M odification of D iet in R enal D isease study equation for J apan. Results Before transplantation, 25 patients (39.7%) were diagnosed with CKD (e GFR , <60 mL/min per 1.73 m 2 ). The incidence of CKD was 22.4% (13/58) at 2 years, 23.2% (13/56) at 3 years and 22.7% (12/54) at 5 years. The patients with CKD at 2 years post‐transplant were more likely to have a history of glomerulonephritis, and were significantly older at the time of LT , compared to those without CKD . Levels of e GFR of less than 60 mL/min per 1.73 m 2 in the first month post‐transplant and a volume of intraoperative blood loss of more than 300 mL/kg were predictive factors for the development of CKD at 2 years post‐transplant and thereafter. Conclusion We have shown that there is an improvement of renal function in the majority of patients after LT . Regardless of the presence of pre‐existing CKD , both renal function status at the first month post‐transplant and a volume of intraoperative blood loss were predictive factors for the development of CKD at 2 years post‐transplant and thereafter.