Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: Lack of renal function recovery (RFR), 90 days after acute kidney injury (AKI) is a contributor to inferior renal outcomes and mortality. Ischemia and reperfusion during kidney transplantation contributes to AKI and DGF, a severe form of AKI. Our aim was to analyze the long-term prognostic implications of RFR at 90 days, in recipients with and without DGF.
Methods: This was a retrospective analysis of adult deceased donor kidney transplant recipients (1996 -2016). Outcome of interest was death censored graft failure (DCGF). RFR was calculated using the formula (observed GFR/predicted GFR) X 100. Predicted GFR was half of the donor GFR plus pre-emptive recipient GFR, and observed GFR was the average of 3 best values, 90 days post-transplant.
Results: 941 recipients were eligible for analysis, of which 25% had DGF. RFR was divided into 3 tertiles <75% (360), 75-100% (218) and >100% (363). Higher DCGF was noted in recipients that developed DGF, and had RFR<75%. In recipients that developed DGF, RFR had no further prognostic implications on DCGF. However, in those that did not develop DGF, RFR<75% was associated with an 82% and 89% higher DCGF in uni- and multi-variate analysis, respectively.
Conclusion: In recipients that do not develop DGF, 90-day RFR<75% was associated with DCGF. This indicates the prognostic relevance of RFR as a short-term outcome as most kidney transplants do not develop DGF. We propose that to truly capture the impact of AKI and ischemia and reperfusion injury during the kidney transplantation surgery, one must quantify RFR over 90 days after transplant.
|Table 1: Hazard ratio for DCGF (significant values in bold)|
|Variable||Univariate analysis: HR (95% CI)||Multivariate analysis: HR (95% CI)|
|75-100||1.16 (0.75-1.80)||1.28 (0.81-2.03)|
|<75||2.03 (1.40-2.92)||2.01 (1.35-2.97)|
|DGF||2.11 (1.52-2.96)||1.77 (1.23-2.53)|
|RFR 75-100||1.03 (0.61-1.73)||1.09 (0.63-1.86)|
|RFR<75||1.82 (1.15-2.88)||1.89 (1.16-3.08)|
|RFR 75-100||1.66 (0.72-3.84)||2.02 (0.81-5.04)|
|RFR<75||1.72 (0.87-3.40)||1.50 (0.67-3.31)|
CITATION INFORMATION: Sandal S., Cantarovich M., Ramankumar A., Saberi N., Saw C., Baran D., Chaudhury P., Paraskevas S., Tchervenkov J. The Prognostic Implications of Renal Function Recovery and Delayed Graft Function in Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Sandal S, Cantarovich M, Ramankumar A, Saberi N, Saw C, Baran D, Chaudhury P, Paraskevas S, Tchervenkov J. The Prognostic Implications of Renal Function Recovery and Delayed Graft Function in Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/the-prognostic-implications-of-renal-function-recovery-and-delayed-graft-function-in-kidney-transplantation/. Accessed March 8, 2021.
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