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Creatinine clearance and hemoglobin concentration before and after heart transplantation

Massimo Cirillo1, Luca S De Santo, Rosa Maria Pollastro

  • 1Departments of Nephrology and Heart Surgery, Second University of Naples, Naples, Italy. massimo.cirillo@unina2.it

Seminars in Nephrology
|November 22, 2005
PubMed

Insights

Glomerular filtration rate (GFR) is a key indicator for heart failure and transplant outcomes. Post-heart transplant, declining kidney function, measured by creatinine clearance, is linked to mortality, influenced by various factors.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Glomerular filtration rate (GFR) indices, such as serum creatinine and creatinine clearance, are established predictors of mortality in congestive heart failure (CHF) and post-heart transplantation.
  • Kidney function is a critical factor influencing long-term outcomes in patients undergoing heart transplantation.

Purpose of the Study:

  • To investigate the association between pre-transplant and post-transplant creatinine clearance and 5-year mortality in heart transplant recipients.
  • To identify factors that may confound the relationship between kidney function and mortality after heart transplantation.

Main Methods:

  • Prospective follow-up of 160 heart transplant recipients for 5 years.
  • Measurement of creatinine clearance before and at serial time points after heart transplantation.
  • Statistical analysis to assess the association between creatinine clearance and mortality, considering potential confounders.

Main Results:

  • Pre-transplant creatinine clearance was not significantly associated with 5-year mortality.
  • Creatinine clearance significantly decreased after heart transplantation, showing a linear trend up to 3 years in patients with complete follow-up.
  • The relationship between kidney function and mortality was influenced by confounders including cause of heart disease, co-morbidity, anemia, and the post-transplant decline in kidney function.

Conclusions:

  • While pre-transplant kidney function may not directly predict mortality, a significant decline in creatinine clearance post-heart transplantation is observed.
  • The impact of kidney function on mortality after heart transplantation is complex and modulated by multiple clinical factors.
  • Monitoring kidney function and addressing confounders are crucial for improving long-term survival in heart transplant recipients.

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