Comanagement With Nephrologist Care Is Associated With Fewer Cardiovascular Events Among Liver Transplant Recipients With Chronic Kidney Disease

Campbell, Pam; Kosirog, Megan; Aghaulor, Blessing; Gregory, Dyanna L.; Pine, Stewart; Daud, Amna; Das, Arighno; Finn, Daniel J.; Levitsky, Josh; Holl, Jane L.; Lloyd‐Jones, Donald M.; VanWagner, Lisa B.

doi:10.1097/txd.0000000000001220

Cited by 6 publications

(8 citation statements)

References 25 publications

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“…[13] Similarly, the same group has shown that LT recipients with or at risk of CKD also present a lower probability of CVE if comanaged with a nephrologist. [36] Together with our results, these studies highlight the relevance of establishing multidisciplinary, patient-oriented teams to achieve better CVR control after LT.…”

Section: Discussionsupporting

confidence: 78%

Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation

et al. 2022

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Although liver transplantation (LT) recipients are at high cardiovascular risk (CVR), the management of CVR factors (CVRF) after LT is far from optimal and needs to be improved. For this reason, we developed a multidisciplinary protocol to standardize the identification, risk stratification, management, and targets of therapy of CVRF during the first post-LT year. The grade of identification and control of CVRF 12 months after LT in the postintervention cohort

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Section: Discussionsupporting

confidence: 78%

Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation

et al. 2022

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“…One of the remarkable findings in our study was the low rate of follow-up by the nephrology department despite CKD. In the literature, joint follow-up with nephrology has been associated with fewer cardiovascular events in liver transplant patients [12] and better management both before and after liver [13], heart, and lung [14] transplantation.…”

Section: Discussionmentioning

confidence: 99%

Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT)

Viejo-Boyano¹,

López-Romero²,

D’Marco³

et al. 2023

Preprint

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Background: Chronic kidney disease (CKD) is a common complication of non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD patients under follow-up in Nephrology Department between 2010 to 2020. Statistical analysis was performed between all the risk factors and four dependent variables: end-stage renal disease (ESKD), increased serum creatinine ≥50%, renal replacement therapy (RRT), and death in pre-transplant, peri-transplant and post-transplant period. Results: 74 patients were studied (7 heart transplant, 34 liver transplants, and 33 lung transplant). Patients who were not followed-up by nephrology in the pre-transplant (p&lt;0.027), peri-transplant (p&lt;0.046), and the longest time until outpatient clinic follow-up (HR 1,032) were associated with a higher risk of creatinine increase ≥50%. Receiving a lung transplant conferred higher risk than liver or hear transplant for developing a creatinine increase ≥50% and ESKD. Peri-transplant mechanical ventilation, peri-transplant and post-transplant anticalcineurin overdose, nephrotoxic and the number of hospital admissions were significantly associated to present a creatinine increase ≥50% and develop ESKD. Conclusion: An early follow-up by the nephrology department was associated with a decrease in the worsening of renal function.

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“…In fact, in a recent work, we failed to demonstrate that BP < 130/80 mm Hg was associated with a reduction in CVEs or mortality in LTRs. [1] We also showed that very few (range 3%-14%) LTRs achieve BP < 130/80 mm Hg within the first 6 years after LT. [4] In the current study, data were inadequate to fully assess the potentially deleterious effects of excessive BP lowering or the effects of white coat hypertension (i.e., elevated office BP but out-of-office normotension) or masked hypertension (i.e., office BP in the normotensive range but out-of-office hypertension), which are associated with adverse cardiac risk in the general population. These issues can only be addressed through a rigorous prospective study using medication reconciliation and with the addition of out-of-office BP monitoring, which notably is now recommended by current BP clinical practice guidelines.…”

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confidence: 88%

Multicenter assessment of hypertension management among liver transplantation recipients

Chebrolu

Phipps

Yao

et al. 2022

Liver Transplantation

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Comanagement With Nephrologist Care Is Associated With Fewer Cardiovascular Events Among Liver Transplant Recipients With Chronic Kidney Disease

Abstract: Supplemental Digital Content is available in the text.

Cited by 6 publications

References 25 publications

Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation

Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation

Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT)

Multicenter assessment of hypertension management among liver transplantation recipients

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