Premium
Prevalence and severity of renal dysfunction among 1062 heart transplant patients according to criteria based on serum creatinine and estimated glomerular filtration rate: results from the CAPRI study
Author(s) -
CrespoLeiro Maria G.,
Delgado Juan F.,
Paniagua Maria J.,
Vázquez de Prada Jose A.,
FernandezYañez Juan,
Almenar Luis,
DiazMolina Beatriz,
Roig Eulalia,
Arizón Jose M.,
AlonsoPulpón Luis,
Garrido Iris P.,
Sanz Maria Luisa,
De La Fuente Luis,
Mirabet Sonia,
Manito Nicolas,
Muñiz Javier
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01178.x
Subject(s) - medicine , renal function , kidney disease , creatinine , urology , nephrotoxicity , dialysis , quartile , gastroenterology , kidney , confidence interval
Crespo‐Leiro MG, Delgado JF, Paniagua MJ, Vázquez, de Prada JA, Fernandez‐Yañez J, Almenar L, Diaz‐Molina B, Roig E, Arizón JM, Alonso‐Pulpón L, Garrido IP, Sanz ML, de la Fuente L, Mirabet S, Manito N, Muñiz J. Prevalence and severity of renal dysfunction among 1062 heart transplant patients according to criteria based on serum creatinine and estimated glomerular filtration rate: results from the CAPRI study.
Clin Transplant 2010: 24: E88–E93.
© 2009 John Wiley & Sons A/S. Abstract: Chronic kidney disease (CKD) is staged on the basis of glomerular filtration rate; generally, the MDRD study estimate, eGFR, is used. Renal dysfunction (RD) in heart transplant (HT) patients is often evaluated solely in terms of serum creatinine (SCr). In a cross‐sectional, 14‐center study of 1062 stable adult HT patients aged 59.1 ± 12.5 yr (82.3% men), RD was graded as absent‐or‐mild (AoM), moderate, or severe (this last including dialysis and kidney graft) by two classifications: SCr‐RD (SCr cutoffs 1.6 and 2.5 mg/dL) and eGFR‐RD (eGFR cutoffs 60 and 30 mL/min/1.73 m 2 ). SCr‐RD was AoM in 68.5% of patients, moderate in 24.9%, and severe in 6.7%; eGFR‐RD, AoM in 38.6%, moderate in 52.2%, severe in 9.2%. Among patients evaluated <2.7, 2.7‐6.2, 6.2‐9.5 and >9.5 yr post‐HT (the periods defined by time‐since‐transplant quartiles), AoM/moderate/severe RD prevalences were <2.7, SCr‐RD 74/21/5%, eGFR‐RD 47/47/6%; 2.7‐6.2, SCr‐RD 73/22/5%, eGFR‐RD 37/56/7%; 6.2–9.5, SCr‐RD 69/24/7%, eGFR‐RD 37/54/9%; >9.5, SCr‐RD 58/32/10%, eGFR‐RD 32/52/16%. The prevalence of severe RD increases with time since transplant. If the usual CKD stages are appropriate for HT patients, the need for less nephrotoxic immunosuppressants and other renoprotective measures is greater than is suggested by direct SCr‐based grading, which should be abandoned as excessively insensitive.