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Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study

Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who...

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Autores principales: Jeon, Junseok, Park, Hyejeong, Kim, Youngha, Kang, Danbee, Lee, Jung Eun, Huh, Wooseong, Guallar, Eliseo, Cho, Juhee, Jang, Hye Ryoun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584983/
https://www.ncbi.nlm.nih.gov/pubmed/34768634
http://dx.doi.org/10.3390/jcm10215110
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author Jeon, Junseok
Park, Hyejeong
Kim, Youngha
Kang, Danbee
Lee, Jung Eun
Huh, Wooseong
Guallar, Eliseo
Cho, Juhee
Jang, Hye Ryoun
author_facet Jeon, Junseok
Park, Hyejeong
Kim, Youngha
Kang, Danbee
Lee, Jung Eun
Huh, Wooseong
Guallar, Eliseo
Cho, Juhee
Jang, Hye Ryoun
author_sort Jeon, Junseok
collection PubMed
description Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who received HT between 2008 and 2016 and survived until discharge after HT were analyzed. The median (interquartile range) age was 52 (40–60) years, and 68.1% were male. Perioperative renal replacement therapy (RRT) was performed in 27.8% of patients. During 2.8 years of median followup, end-stage kidney disease (ESKD) developed in 12 patients (1.8%). In a fully adjusted model, RRT > 3 weeks, the use of inotropes/vasopressors and non-use of ACEi/ARB were associated with ESKD. Preexisting renal disease tended to be associated with ESKD. Among the 561 patients without preexisting CKD, 104 (18.5%) developed chronic kidney disease (CKD). Age, extracorporeal membrane oxygenation, and RRT were associated with the development of CKD after HT. Our nationwide cohort study demonstrated that perioperative RRT was a predictor of poor renal outcomes after HT. These results suggest that an active renoprotective strategy is required during the perioperative period.
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spelling pubmed-85849832021-11-12 Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study Jeon, Junseok Park, Hyejeong Kim, Youngha Kang, Danbee Lee, Jung Eun Huh, Wooseong Guallar, Eliseo Cho, Juhee Jang, Hye Ryoun J Clin Med Article Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who received HT between 2008 and 2016 and survived until discharge after HT were analyzed. The median (interquartile range) age was 52 (40–60) years, and 68.1% were male. Perioperative renal replacement therapy (RRT) was performed in 27.8% of patients. During 2.8 years of median followup, end-stage kidney disease (ESKD) developed in 12 patients (1.8%). In a fully adjusted model, RRT > 3 weeks, the use of inotropes/vasopressors and non-use of ACEi/ARB were associated with ESKD. Preexisting renal disease tended to be associated with ESKD. Among the 561 patients without preexisting CKD, 104 (18.5%) developed chronic kidney disease (CKD). Age, extracorporeal membrane oxygenation, and RRT were associated with the development of CKD after HT. Our nationwide cohort study demonstrated that perioperative RRT was a predictor of poor renal outcomes after HT. These results suggest that an active renoprotective strategy is required during the perioperative period. MDPI 2021-10-30 /pmc/articles/PMC8584983/ /pubmed/34768634 http://dx.doi.org/10.3390/jcm10215110 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jeon, Junseok
Park, Hyejeong
Kim, Youngha
Kang, Danbee
Lee, Jung Eun
Huh, Wooseong
Guallar, Eliseo
Cho, Juhee
Jang, Hye Ryoun
Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_full Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_fullStr Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_full_unstemmed Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_short Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_sort prognostic factors of renal outcomes after heart transplantation: a nationwide retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584983/
https://www.ncbi.nlm.nih.gov/pubmed/34768634
http://dx.doi.org/10.3390/jcm10215110
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