Cargando…

Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis

Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies as...

Descripción completa

Detalles Bibliográficos
Autores principales: Thongprayoon, Charat, Kaewput, Wisit, Thamcharoen, Natanong, Bathini, Tarun, Watthanasuntorn, Kanramon, Lertjitbanjong, Ploypin, Sharma, Konika, Salim, Sohail Abdul, Ungprasert, Patompong, Wijarnpreecha, Karn, Kröner, Paul T., Aeddula, Narothama Reddy, Mao, Michael A, Cheungpasitporn, Wisit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463182/
https://www.ncbi.nlm.nih.gov/pubmed/30884912
http://dx.doi.org/10.3390/jcm8030372
_version_ 1783410720546750464
author Thongprayoon, Charat
Kaewput, Wisit
Thamcharoen, Natanong
Bathini, Tarun
Watthanasuntorn, Kanramon
Lertjitbanjong, Ploypin
Sharma, Konika
Salim, Sohail Abdul
Ungprasert, Patompong
Wijarnpreecha, Karn
Kröner, Paul T.
Aeddula, Narothama Reddy
Mao, Michael A
Cheungpasitporn, Wisit
author_facet Thongprayoon, Charat
Kaewput, Wisit
Thamcharoen, Natanong
Bathini, Tarun
Watthanasuntorn, Kanramon
Lertjitbanjong, Ploypin
Sharma, Konika
Salim, Sohail Abdul
Ungprasert, Patompong
Wijarnpreecha, Karn
Kröner, Paul T.
Aeddula, Narothama Reddy
Mao, Michael A
Cheungpasitporn, Wisit
author_sort Thongprayoon, Charat
collection PubMed
description Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies assessing the incidence of AKI (using a standard AKI definition) in adult patients undergoing LTx. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, the generic inverse variance approach of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018100664). Results: Thirty-eight cohort studies, with a total of 13,422 LTx patients, were enrolled. Overall, the pooled estimated incidence rates of post-LTx AKI and severe AKI requiring renal replacement therapy (RRT) were 40.7% (95% CI: 35.4%–46.2%) and 7.7% (95% CI: 5.1%–11.4%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of post-LTx AKI (p = 0.81). The pooled estimated in-hospital or 30-day mortality, and 1-year mortality rates of patients with post-LTx AKI were 16.5% (95% CI: 10.8%–24.3%) and 31.1% (95% CI: 22.4%–41.5%), respectively. Post-LTx AKI and severe AKI requiring RRT were associated with significantly higher mortality with pooled ORs of 2.96 (95% CI: 2.32–3.77) and 8.15 (95%CI: 4.52–14.69), respectively. Compared to those without post-LTx AKI, recipients with post-LTx AKI had significantly increased risk of liver graft failure and chronic kidney disease with pooled ORs of 3.76 (95% CI: 1.56–9.03) and 2.35 (95% CI: 1.53–3.61), respectively. Conclusion: The overall estimated incidence rates of post-LTx AKI and severe AKI requiring RRT are 40.8% and 7.0%, respectively. There are significant associations of post-LTx AKI with increased mortality and graft failure after transplantation. Furthermore, the incidence of post-LTx AKI has remained stable over the ten years of the study.
format Online
Article
Text
id pubmed-6463182
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-64631822019-04-19 Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis Thongprayoon, Charat Kaewput, Wisit Thamcharoen, Natanong Bathini, Tarun Watthanasuntorn, Kanramon Lertjitbanjong, Ploypin Sharma, Konika Salim, Sohail Abdul Ungprasert, Patompong Wijarnpreecha, Karn Kröner, Paul T. Aeddula, Narothama Reddy Mao, Michael A Cheungpasitporn, Wisit J Clin Med Article Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies assessing the incidence of AKI (using a standard AKI definition) in adult patients undergoing LTx. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, the generic inverse variance approach of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018100664). Results: Thirty-eight cohort studies, with a total of 13,422 LTx patients, were enrolled. Overall, the pooled estimated incidence rates of post-LTx AKI and severe AKI requiring renal replacement therapy (RRT) were 40.7% (95% CI: 35.4%–46.2%) and 7.7% (95% CI: 5.1%–11.4%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of post-LTx AKI (p = 0.81). The pooled estimated in-hospital or 30-day mortality, and 1-year mortality rates of patients with post-LTx AKI were 16.5% (95% CI: 10.8%–24.3%) and 31.1% (95% CI: 22.4%–41.5%), respectively. Post-LTx AKI and severe AKI requiring RRT were associated with significantly higher mortality with pooled ORs of 2.96 (95% CI: 2.32–3.77) and 8.15 (95%CI: 4.52–14.69), respectively. Compared to those without post-LTx AKI, recipients with post-LTx AKI had significantly increased risk of liver graft failure and chronic kidney disease with pooled ORs of 3.76 (95% CI: 1.56–9.03) and 2.35 (95% CI: 1.53–3.61), respectively. Conclusion: The overall estimated incidence rates of post-LTx AKI and severe AKI requiring RRT are 40.8% and 7.0%, respectively. There are significant associations of post-LTx AKI with increased mortality and graft failure after transplantation. Furthermore, the incidence of post-LTx AKI has remained stable over the ten years of the study. MDPI 2019-03-17 /pmc/articles/PMC6463182/ /pubmed/30884912 http://dx.doi.org/10.3390/jcm8030372 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thongprayoon, Charat
Kaewput, Wisit
Thamcharoen, Natanong
Bathini, Tarun
Watthanasuntorn, Kanramon
Lertjitbanjong, Ploypin
Sharma, Konika
Salim, Sohail Abdul
Ungprasert, Patompong
Wijarnpreecha, Karn
Kröner, Paul T.
Aeddula, Narothama Reddy
Mao, Michael A
Cheungpasitporn, Wisit
Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title_full Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title_fullStr Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title_full_unstemmed Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title_short Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis
title_sort incidence and impact of acute kidney injury after liver transplantation: a meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463182/
https://www.ncbi.nlm.nih.gov/pubmed/30884912
http://dx.doi.org/10.3390/jcm8030372
work_keys_str_mv AT thongprayooncharat incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT kaewputwisit incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT thamcharoennatanong incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT bathinitarun incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT watthanasuntornkanramon incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT lertjitbanjongploypin incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT sharmakonika incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT salimsohailabdul incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT ungprasertpatompong incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT wijarnpreechakarn incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT kronerpault incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT aeddulanarothamareddy incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT maomichaela incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis
AT cheungpasitpornwisit incidenceandimpactofacutekidneyinjuryafterlivertransplantationametaanalysis