The natural history of renal function following orthotopic heart transplant

Al‐Aly, Ziyad; Abbas, Samer R.; Moore, Eric; Diallo, Ousmane; Hauptman, Paul J.; Bastani, Bahar

doi:10.1111/j.1399-0012.2005.00408.x

Cited by 87 publications

(31 citation statements)

References 36 publications

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“…(Pediatric Transplantation, in press ) revealed as much as 67% of patients demonstrating CKD stage 2 or higher at five yr after pediatric heart transplantation. A similar study on 48 heart transplant patients reported a GFR below 30 mL/min/1.73 m 2 in 4.2%, 10.4% and 12.5% of the patients at 5, 10 and 15 yr, respectively (7). An adult study on 219 lung and heart–lung transplant recipients, with a median follow‐up of 79 months, reported a doubling of serum creatinine in 55% of patients and progression to ESRD in 7.3% of patients (8).…”

mentioning

confidence: 90%

How to monitor renal function in pediatric solid organ transplant recipients

Filler

Sharma

2007

Pediatric Transplantation

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The aim is to review the tools for early detection of renal dysfunction after pediatric solid organ transplantation. Currently, the most widely used marker for detection of renal dysfunction involves measurement of GFR. Inulin clearance forms the "gold standard" method for measuring GFR; however, nuclear medicine methods ((51)Cr EDTA and (99)Tc DTPA isotope clearance studies) have replaced inulin clearance. The measurement of serum creatinine has a low sensitivity for the early detection of renal damage. The Schwartz formula using patient height and serum creatinine requires center-specific constants and has limitations associated with creatinine determination. These limitations may be overcome using a cystatin C-based GFR estimation. In diabetic nephropathy, and more recently in hemolytic uremic syndrome, microalbuminuria has been established as a useful screening tool for renal damage, while its predictive value in the transplantation setting needs to be established. All transplant recipients should be screened for hypertension. Early referral for ambulatory 24-h blood pressure monitoring and involvement of pediatric nephrologists should be considered. All pediatric solid organ transplant recipients receiving CNI should be screened regularly for high blood pressure and early evidence of renal damage using either GFR scans or cystatin C-based GFR estimations.

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mentioning

confidence: 90%

How to monitor renal function in pediatric solid organ transplant recipients

Filler

Sharma

2007

Pediatric Transplantation

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“…Such a practice seems justifiable in view of the documented poor outcomes in patients with pre‐existing renal impairment undergoing heart or lung transplantation alone. Furthermore, it is well documented that there is significant loss of glomerular filtration rate in the post‐heart and lung transplant period, especially in patients with pre‐existing renal impairment . This would confer very poor renal survival in patients with significantly reduced kidney function undergoing heart or lung transplantation alone.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of simultaneous heart–kidney and lung–kidney transplantations: the Australian and New Zealand experience

Ruderman

Sevastos

Anthony

et al. 2015

Internal Medicine Journal

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“…Some centers actually report an improvement in kidney function in the first year following cardiac transplant and stabilization thereafter [9]. In adult studies, there is an increased risk of mortality associated with development of CKD [35, 36]. …”

Section: Cardiac Transplantationmentioning

confidence: 99%

“…Additional risk factors for developing ESRD included pretransplant diabetes and intensive care unit stay or extracorporeal membrane oxygenation [37]. In the adult population, several risk factors for CKD development have been identified and include older age at transplant, pretransplant serum creatinine, preexisting diabetes, abnormal GFR at 1 year after transplant, hypertension after transplant, and cyclosporine immunosuppression within the first 6 months after transplant [12, 35, 36, 38, 39]. Risk factors for progression to ESRD include postoperative development of hypertension and proteinuria of >1 g/24 h [13, 40].…”

Section: Cardiac Transplantationmentioning

confidence: 99%

Chronic kidney disease after liver, cardiac, lung, heart–lung, and hematopoietic stem cell transplant

Hingorani

2008

Pediatr Nephrol

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Patient survival after cardiac, liver, and hematopoietic stem cell transplant (HSCT) is improving; however, this survival is limited by substantial pretransplant and treatmentrelated toxicities. A major cause of morbidity and mortality after transplant is chronic kidney disease (CKD). Although the majority of CKD after transplant is attributed to the use of calcineurin inhibitors, various other conditions such as thrombotic microangiopathy, nephrotic syndrome, and focal segmental glomerulosclerosis have been described. Though the immunosuppression used for each of the transplant types, cardiac, liver and HSCT is similar, the risk factors for developing CKD and the CKD severity described in patients after transplant vary. As the indications for transplant and the long-term survival improves for these children, so will the burden of CKD. Nephrologists should be involved early in the pretransplant workup of these patients. Transplant physicians and nephrologists will need to work together to identify those patients at risk of developing CKD early to prevent its development and progression to end-stage renal disease.

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The natural history of renal function following orthotopic heart transplant

Cited by 87 publications

References 36 publications

How to monitor renal function in pediatric solid organ transplant recipients

How to monitor renal function in pediatric solid organ transplant recipients

Outcomes of simultaneous heart–kidney and lung–kidney transplantations: the Australian and New Zealand experience

Chronic kidney disease after liver, cardiac, lung, heart–lung, and hematopoietic stem cell transplant

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