Renal Risk Index and Acute Kidney Injury in Liver Transplant Patients.
University of Michigan, Ann Arbor, MI.
Meeting: 2016 American Transplant Congress
Abstract number: B170
Keywords: Post-operative complications, Prediction models, Renal dysfunction, Risk factors
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Kidney Issue in Liver Transplantation
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: Renal risk index (RRI) has been validated in liver transplant (LT) to predict post-transplant ESRD. We examined the clinical utility of RRI as a prognostic tool for acute kidney injury (AKI) after LT.
Methods: Data were collected from adult LT recipients at University of Michigan between 1/1/10 and 9/8/15. RRI was calculated using 14 pre-transplant characteristics (https://rri.med.umich.edu).
Renal outcomes within the first 7 days of LT were classified by RIFLE criteria as: no AKI (Class N), risk (Class R), injury (Class I), or failure (Class F). Patients (pts) who received chronic dialysis for > 3 months pre-LT or died within 7 days post-LT were excluded. All pts received tacrolimus as part of immunosuppression. We compared RRI among Classes N-F using Kruskal-Wallis test. Next we combined N and R (Class NR) and I and F (Class IF or severe AKI). Mann-Whitney U test was used to compare RRI between Class NR and IF.
Results: Of the 296 pts, 212 (71.6%) developed severe AKI and 41 (13.9%) required dialysis within the first 7 days of LT. Distribution of RRI was significantly different among Classes N-F. Mean RRI in Class NR was significantly higher than Class IF. Mean eGFR for Class IF was significantly lower than Class NR at 6 months and 1 year after LT. Only 2 pts from Class NR and 6 pts from Class IF developed ESRD at 1 year. All data are presented in mean ± SD.
| AKI Class | Class N (N=44) | Class R (N=40) | Class I (N=104) | Class F (N=108) | P value |
| RRI | 1.86±1.92 | 1.22±1.73 | 1.95±1.53 | 3.32±4.17 | <0.0001 |
| Severe AKI Class | Class NR (N=84) | Class IF (N=212) | |||
| RRI | 1.56±1.68 | 2.64±3.23 | <0.0001 | ||
| MDRD4 eGFR at 6 months (mL/min) | 74±30 | 66±25 | 0.04 | ||
| MDRD4 eGFR at 1 year (mL/min) | 72±30 | 61±27 | 0.003 | ||
Conclusion: Severe AKI was common in the early post-LT period. A higher RRI at LT was associated with severe AKI in the early post-LT period. Majority of pts with severe AKI recovered their renal function; however, they were more likely to have lower eGFR at 6 months and 1 year after LT. Strategies for renal protection targeting high RRI pts should be tested to decrease the incidence of post-LT AKI and progression to CKD.
CITATION INFORMATION: Neal J, Sun Y, Erley J, Shen J, Sonnenday C, Sharma P, Park J. Renal Risk Index and Acute Kidney Injury in Liver Transplant Patients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Neal J, Sun Y, Erley J, Shen J, Sonnenday C, Sharma P, Park J. Renal Risk Index and Acute Kidney Injury in Liver Transplant Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/renal-risk-index-and-acute-kidney-injury-in-liver-transplant-patients/. Accessed March 29, 2020.« Back to 2016 American Transplant Congress