Prevalence of acute kidney injury after liver transplantation in children: Comparison of the pRIFLE, AKIN, and KDIGO criteria using corrected serum creatinine

Nahum, Elhanan; Kadmon, Gili; Kaplan, Eytan; Weissbach, Avichai; Hijazi, Hanan; Haskin, Orly; Mozer‐Glassberg, Yael

doi:10.1016/j.jcrc.2019.01.010

Cited by 15 publications

(19 citation statements)

References 23 publications

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“…1 Likewise, AKI after pediatric LTx is common with investigators reporting incidence rates ranging from 28% to 57% based on differing criteria used to define AKI. [2][3][4] Consistent with what is shown in other patient groups, AKI after pediatric LTx is associated with a significantly longer duration of mechanical ventilation, an increased hospital length of stay, and an increased risk of mortality. 3,4 Furthermore, AKI is a well-known risk factor for the development of chronic kidney damage and longitudinal studies have demonstrated the presence of renal insufficiency in a substantial proportion of the LTx population, including children.…”

Section: Introductionsupporting

confidence: 69%

“…[2][3][4] Consistent with what is shown in other patient groups, AKI after pediatric LTx is associated with a significantly longer duration of mechanical ventilation, an increased hospital length of stay, and an increased risk of mortality. 3,4 Furthermore, AKI is a well-known risk factor for the development of chronic kidney damage and longitudinal studies have demonstrated the presence of renal insufficiency in a substantial proportion of the LTx population, including children. 5,6 The standard biomarker to asses AKI in children is serum creatinine; however, serum creatinine is commonly recognized to be a late and insensitive marker of AKI with changes often not apparent until 48-72 hours after injury.…”

Section: Introductionsupporting

confidence: 69%

“…The incidence of AKI of 37.5% in our patient cohort is similar to what has been shown in previous studies. [2][3][4] Patients that were diagnosed with AKI were diagnosed between days 2 and 4, and hence, more than 24 hours passed before AKI could be diagnosed using standard clinical criteria with serum creatinine. Our study results show NGAL and [TIMP-2]• [IGFBP7] are good predictors of AKI when measured within 6 hours after surgery.…”

Section: Resultsmentioning

confidence: 99%

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The use of urinary biomarkers to predict acute kidney injury in children after liver transplant

Fuhrman

Kellum²,

Joyce

et al. 2019

Pediatric Transplantation

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Background: AKI after pediatric liver transplantation is associated with increased morbidity and mortality. The role of urinary biomarkers for the prediction of AKI in pediatric patients after liver transplantation has not been previously reported. The primary objective of this prospective pilot study was to determine the predictive capabilities of urinary KIM-1, NGAL, TIMP-2, and IGFBP7 for diagnosing AKI. Methods: Sixteen children undergoing liver transplantation were enrolled in the study over a 19month time period. The Kidney Disease Improving Outcomes criteria for urine output and serum creatinine were used to define AKI. Predictive ability was evaluated using the area under the curve obtained by ROC analysis.

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Section: Introductionsupporting

confidence: 69%

Section: Introductionsupporting

confidence: 69%

Section: Resultsmentioning

confidence: 99%

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The use of urinary biomarkers to predict acute kidney injury in children after liver transplant

Fuhrman

Kellum²,

Joyce

et al. 2019

Pediatric Transplantation

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“…In particular, pRIFLE detected AKI in 57% of patients, whereas AKIN and KDIGO criteria in only 43% of them. A good correlation among the three criteria was assessed with a close relation between kidney failure, duration of mechanical ventilation, and Intensive Care Unit (ICU) stay 43 . Immunosuppressant use, blood loss, blood product transfusion during surgery and hemodynamic instability represented the main clinical factors influencing AKI development 44,45 …”

Section: Acute Kidney Injury After Pediatric Ltxmentioning

confidence: 99%

“…A good correlation among the three criteria was assessed with a close relation between kidney failure, duration of mechanical ventilation, and Intensive Care Unit (ICU) stay. 43 Immunosuppressant use, blood loss, blood product transfusion during surgery and hemodynamic instability represented the main clinical factors influencing AKI development. 44,45 Furthermore, it was revealed that patients with biliary atresia, increased time of anhepatic phase and a lower postoperative jaundice clearance had an increased risk of AKI too.…”

Section: Acute K Idne Y Inj Ury Af Ter Ped Iatri C Lt Xmentioning

confidence: 99%

Acute and chronic kidney disease after pediatric liver transplantation: An underestimated problem

Lacquaniti

Campo

Tocco

et al. 2020

Clinical Transplantation

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Acute and chronic kidney injuries represent critical issues after liver transplantation (LTx), but whereas renal dysfunction in adult transplant patients is well documented, little is known about its prevalence in childhood. It is a challenge to accurately evaluate renal function in patients with liver disease, due to several confounding factors. Creatinine-based equations estimating glomerular filtration rate, validated in nephropathic patients without hepatic issues, are frequently inaccurate in end-stage liver disease, underestimating the real impact of renal disease. Moreover, whereas renal issues observed within 1 year from LTx were often related to acute injuries, kidney damage observed after 5-7 years from LTx, is due to chronic, irreversible mechanisms. Most immunosuppression protocols are based on calcineurin inhibitors (CNIs) and corticosteroids, but mycophenolate mofetil or sirolimus could play significant roles, also in children. Early diagnosis and personalized treatment represent the bases of kidney disease management, in order to minimize its close relation with increased mortality. This review analyzed acute and chronic kidney damage after pediatric LTx, also discussing the impact of pre-existent renal disease. The main immunosuppressant strategies have been reviewed, highlighting their impact on kidney function. Different methods assessing renal function were reported, with the potential application of new renal biomarkers.

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Acute kidney injury after living‐related liver transplantation in infants with biliary atresia: A retrospective study

Liu,

Dai,

Guo

et al. 2023

Pediatric Discovery

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Although acute kidney injury (AKI) is a frequent postoperative complication after liver transplantation, renal function following living‐related liver transplantation (LRLT) in infants remains understudied. The aim of this study was to identify the prevalence of AKI and the impact of AKI on outcomes in infant recipients with biliary atresia. We retrospectively reviewed infants who underwent LRLT surgery between January 2018 and January 2021. The primary outcome was the risk of postoperative AKI occurrence in the first 7 postoperative days. A multivariate regression analysis model was used to investigate risk factors for AKI, and the incidence and impacts of AKI on outcomes were analyzed. A total of 98 patients were included in the analysis. AKI occurred in 59 patients (60.2%) within 7 days after surgery. Logistic regression analysis revealed that preoperative transfusion (p < 0.05) and lower serum creatinine (SCr) (p < 0.05) were independent risk factors for AKI. The incidence of serious complications was significantly higher in the AKI group than in the non‐AKI group (p < 0.05). The postoperative mechanical ventilation time (p < 0.05) and hospital stay (p = 0.019) were significantly longer in the AKI group. There was no evidence of chronic kidney disease (CKD) in any surviving infants within 1 year after surgery. In conclusion, AKI is common in infant LRLT (60.2%), and preoperative transfusion and lower SCr levels were independently associated with AKI. AKI may be associated with the incidence of serious complications, prolonged use of ventilators, and hospital stays. No CKD occurred within 1 year.

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Prevalence of acute kidney injury after liver transplantation in children: Comparison of the pRIFLE, AKIN, and KDIGO criteria using corrected serum creatinine

Cited by 15 publications

References 23 publications

The use of urinary biomarkers to predict acute kidney injury in children after liver transplant

The use of urinary biomarkers to predict acute kidney injury in children after liver transplant

Acute and chronic kidney disease after pediatric liver transplantation: An underestimated problem

Acute kidney injury after living‐related liver transplantation in infants with biliary atresia: A retrospective study

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