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Chronic Kidney Disease in Solid-Organ Transplantation

  • Brent W. Miller
    Correspondence
    Address Correspondence to Brent W. Miller, MD, 4205 Forest Park Avenue, St. Louis, Missouri 63108.
    Affiliations
    Renal Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO.
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      As the long-term survival of nonrenal solid-organ transplant recipients continues to improve, more complications related to transplantation occur. Among the most serious is chronic kidney disease (CKD). Although CKD was previously thought to only clinically affect a minority of this population, closer measurements of kidney function and monitoring of CKD complications now show that CKD will affect a significant number, if not a majority, of transplant recipients—particularly the long-term survivors who often have excellent function of their primary allograft. This article will review the incidence, risk factors, treatment, and outcomes of patients who develop CKD after heart, liver, and lung transplantation.

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      References

      1. Based on OPTN data as of July 22, 2005

        • Adler A.I.
        • Stevens R.J.
        • Manley S.E.
        • et al.
        Development and progression of nephropathy in type 2 diabetes.
        Kidney Int. 2003; 63: 225-232
        • Moreno J.M.
        • Cuervas-Mons V.
        • Rubio E.
        • et al.
        Chronic renal dysfunction after liver transplantation in adult patients.
        Transplant Proc. 2003; 35: 1907-1908
        • Ojo A.O.
        • Held P.J.
        • Port F.K.
        • et al.
        Chronic renal failure after transplantation of a nonrenal organ.
        N Engl J Med. 2003; 349: 931-940
        • Taylor D.O.
        • Edwards L.B.
        • Boucek M.M.
        • et al.
        The registry of the International Society for Heart and Lung Transplantation.
        J Heart Lung Transplant. 2004; 23: 796-803
        • Trulock E.P.
        • Edwards L.B.
        • Taylor D.O.
        • et al.
        The registry of the International Society for Heart and Lung Transplantation.
        J Heart Lung Transplant. 2004; 23: 804-815
        • Gonwa T.A.
        • Mai M.L.
        • Melton L.B.
        • et al.
        End-stage renal disease (ESRD) after orthotopic liver transplantation (OLTX) using calcineurin-based immunotherapy.
        Transplantation. 2001; 72: 1934-1939
        • Gonwa T.A.
        • Jennings L.
        • Mai M.L.
        • et al.
        Estimation of glomerular filtration rates before and after orthotopic liver transplantation.
        Liver Transplant. 2004; 10: 301-309
        • Agarwala S.
        • Culligan E.
        • Jain A.
        • et al.
        Evaluation of renal function in transplant patients on tacrolimus therapy.
        J Clin Pharm. 2002; 42: 798-805
        • Boerkroellofs J.
        • Stegeman C.A.
        • Navis G.J.
        • et al.
        Creatinine-based estimation of rate of long term renal function loss in lung transplant recipients.
        J Heart Lung Transplant. 2000; 19: 256-262
        • Goral S.
        • Ynares C.
        • Shyr Y.
        • et al.
        Long-term renal function in heart transplant recipients receiving cyclosporine therapy.
        J Heart Lung Transplant. 1997; 16: 1106-1112
        • Freeman R.B.
        • Wiesner R.H.
        • Roberts J.P.
        • et al.
        Improving liver allocation.
        Am J Transplant. 2004; 4: 114-131
        • Merion R.M.
        • Schaub Paramesh A.S.
        • et al.
        Post-liver transplant acute renal failure.
        Clin Transplant. 2004; 18: 94-99
        • Merion R.M.
        • Schaubel D.E.
        • Dykstra D.M.
        • et al.
        The survival benefit of liver transplantation.
        Am J Transplant. 2005; 5: 307-313
        • Narayanan Menon K.V.N.
        • Nyberg S.L.
        • Harmsen W.S.
        • et al.
        MELD and other factors associated with survival after liver transplantation.
        Am J Transplant. 2004; 4: 819-825
        • Canver C.C.
        • Heisey D.M.
        • Nichols R.D.
        Acute renal failure requiring hemodialysis immediately after heart transplantation portends a poor outcome.
        J Cardiovasc Surg. 2000; 41: 203-206
        • Gonwa T.A.
        • Mai M.L.
        • Melton L.B.
        • et al.
        Renal replacement therapy and orthotopic liver transplantation.
        Transplantation. 2001; 71: 1424-1428
        • Lieske J.C.
        • Spargo B.H.
        • Toack F.G.
        Cyclosporine-induced chronic nephropathy.
        J Am Soc Nephrol. 1991; 2: S45-S52
        • Zaltzman J.S.
        • Pei Y.
        • Maurer J.
        • et al.
        Cyclosporine nephrotoxicity in lung transplant recipients.
        Transplantation. 1992; 54: 875-878
        • Soccal P.M.
        • Gasche Y.
        • Favre H.
        • et al.
        Improvement of drug-induced chronic renal failure in lung transplantation.
        Transplantation. 1999; 68: 164-165
        • Angermann C.E.
        • Stork S.
        • Costard-Jackle A.
        • et al.
        Reduction of cyclosporine after introduction of mycophenolate mofetil improves chronic renal dysfunction in heart transplant recipients—the IMPROVED multi-center study.
        Eur Heart J. 2004; 25: 1626-1634
        • Groetzner J.
        • Meiser B.
        • Landwehr P.
        • et al.
        Mycophenolate mofetil and sirolimus as calcineurin inhibitor-free immunosuppression for late cardiac-transplant recipients with chronic renal failure.
        Transplantation. 2004; 77: 568-574
        • Lyster H.
        • Panicker G.
        • Leaver N.
        • et al.
        Initial experience with sirolimus and mycophenolate mofetil for renal rescue from cyclosporine nephrotoxicity after heart transplantation.
        Transplant Proc. 2004; 36: 3167-3170
        • Gardiner S.M.
        • March J.E.
        • Kemp P.A.
        • et al.
        Regional haemodynamic effects of cyclosporine A, tacrolimus, and sirolimus in conscious rats.
        Br J Pharm. 2004; 141: 634-643
        • Butani L.
        Investigation of pediatric renal transplant recipients with heavy proteinuria after sirolimus rescue.
        Transplantation. 2004; 78: 1362-1366
        • Groetzner J.
        • Meiser B.
        • Landwehr P.
        • et al.
        Mycophenolate mofetil and sirolimus as calcineurin inhibitor-free immunosuppression for late cardiac-transplant recipients with chronic renal failure.
        Transplantation. 2004; 77: 568-574
        • Lynn M.
        • Abreo K.
        • Zibari G.
        • et al.
        End-stage renal disease in liver transplants.
        Clin Transplant. 2001; 15: 66-69
        • Hornberger J.
        • Best J.
        • Geppert J.
        • et al.
        Risks and costs of end-stage renal disease after heart transplantation.
        Transplantation. 1998; 66: 1763-1770
        • Frimat L.
        • Villemot J.P.
        • Cormier L.
        • et al.
        Treatment of end-stage renal failure after heart transplantation.
        Neph Dial Transplant. 1998; 13: 2905-2908