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Risk factors associated with moderate‐to‐severe renal dysfunction among heart transplant patients: results from the CAPRI study
Author(s) -
Delgado Juan F.,
CrespoLeiro María G.,
GómezSánchez Miguel A.,
Paniagua María J.,
GonzálezVílchez Francisco,
Vázquez de Prada José A.,
FernándezYáñez Juan,
Pascual David,
Almenar Luis,
MartínezDolz Luis,
Díaz Beatriz,
Roig Eulalia,
Segovia Javier,
Arizón Jose M.,
Garrido Iris,
Blasco Teresa,
López Javier,
Brossa Vicens,
Manito Nicolás,
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.1399-0012.2010.01249.x
Subject(s) - medicine , renal function , tacrolimus , transplantation , immunosuppression , kidney disease , creatinine , calcineurin , logistic regression , risk factor , urology , kidney transplantation
Delgado JF, Crespo‐Leiro MG, Gómez‐Sánchez MA, Paniagua MJ, González‐Vílchez F, Vázquez de Prada JA, Fernández‐Yáñez J, Pascual D, Almenar L, Martínez‐Dolz L, Díaz B, Roig E, Segovia J, Arizón JM, Garrido I, Blasco T, López J, Brossa V, Manito N, Muñiz J. Risk factors associated with moderate‐to‐severe renal dysfunction among heart transplant patients: results from the CAPRI study.
Clin Transplant 2010 DOI: 10.1111/j.1399‐0012.2010.01249.x
© 2010 John Wiley & Sons A/S. Abstract: The longer survival of patients with heart transplantation (HT) favors calcineurin inhibitor–related chronic kidney disease (CKD). It behoves to identify risk factors. At 14 Spanish centers, data on 1062 adult patients with HT (age 59.2 ± 12.3 yr, 82.5% men) were collected at routine follow‐up examinations. Glomerular filtration rate, GFR, was estimated using the four‐variable MDRD equation, and moderate‐or‐severe renal dysfunction (MSRD) was defined as K/DOQI stage 3 CKD or worse. Time since transplant ranged from one month to 22 yr (mean 6.7 yr). At assessment, 26.6% of patients were diabetic and 63.9% hypertensive; 53.9% were taking cyclosporine and 33.1% tacrolimus; and 61.4% had MSRD. Among patients on cyclosporine or tacrolimus at assessment, multivariate logistic regression identified male sex (OR 0.44), pre‐ and post‐HT creatinine (2.73 and 3.13 per mg/dL), age at transplant (1.06 per yr), time since transplant (1.05 per yr), and tacrolimus (0.65) as independent positive or negative predictors of MSRD. It is concluded that female sex, pre‐ and one‐month post‐HT serum creatinine, age at transplant, time since transplant, and immunosuppression with cyclosporine rather than tacrolimus may all be risk factors for development of CKD ≥ stage 3 by patients with HT.