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Updated: Jun 13, 2026
Transdermal Measurement of Glomerular Filtration Rate in Mice
Published on: October 21, 2018
Prognostic value of glomerular filtration rate 1 year after heart transplantation
Josep Navarro-Manchón1, Luis Martínez-Dolz, Luis Almenar
1Unidad de Trasplante Cardiaco e Insuficiencia Cardiaca, Hospital Universitario La Fe, Valencia, Spain. villacampus@hotmail.com
Insights
Severe kidney dysfunction one year after heart transplantation (HT) significantly increases mortality risk. Early identification of low glomerular filtration rate (GFR) is crucial for improving long-term survival in HT patients.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Renal failure is a significant complication following heart transplantation (HT), with varying prevalence estimates due to diverse definitions.
- The impact of renal dysfunction on long-term mortality after HT requires further investigation.
Purpose of the Study:
- To examine the association between glomerular filtration rate (GFR) one year post-transplantation and subsequent mortality.
- To identify GFR as a predictor of long-term survival in heart transplant recipients.
Main Methods:
- Glomerular filtration rate (GFR) was measured in 316 heart transplant patients at one year post-transplant using the abbreviated Modification of Diet in Renal Disease Study formula.
- Patients were stratified into three GFR groups (<30, 30-59, and ≥60 mL/min per 1.73 m²).
- Cox regression analysis was employed to evaluate the relationship between GFR and mortality, controlling for other factors.
Main Results:
- No significant differences in rejection or infection rates were observed among the GFR groups within the first year.
- Over a mean follow-up of 6.3 years, mortality was substantially higher in patients with GFR <30 mL/min per 1.73 m² (74%) compared to those with GFR 30-59 (30%) or ≥60 (24%).
- A GFR <30 mL/min per 1.73 m² at one year was the sole independent predictor of long-term mortality (hazard ratio = 2.87).
Conclusions:
- Severe renal dysfunction identified one year after heart transplantation is an independent predictor of long-term all-cause mortality.
- Monitoring GFR post-transplant is critical for risk stratification and potentially improving outcomes in heart transplant recipients.
Introduction And Objectives:
The development of renal failure is one of the most important problems after heart transplantation (HT), but the wide range of definitions means that estimates of its prevalence vary considerably. Furthermore, its impact on mortality has not been adequately studied. The objective was to investigate the relationship between the glomerular filtration rate (GFR) 1 year after transplantation and mortality during follow-up.
Methods:
The GFR was determined in 316 patients still living 1 year after transplantation using the abbreviated Modification of Diet in Renal Disease Study formula. Patients were divided into three groups according to GFR (i.e. <30, 30-59 and > or =60 mL/min per 1.73 m2) and pretransplant variables and rejection and infection rates within the first year were analyzed. The association between GFR at 1 year and mortality during follow-up was evaluated and reasons for the association were examined.
Results:
There was no difference in the number of rejections or infections in the first year between the three groups. During a mean follow-up period of 6.3 years, 74% of patients with a GFR <30 mL/min per 1.73 m2 died, compared with 24% and 30% of those with a GFR > or =60 and 30-59 mL/min per 1.73 m2, respectively. Survival analysis (i.e. Cox regression analysis) demonstrated a significant difference between patients with a GFR <30 mL/min per 1.73 m2 and other patients (P< .001). A very low GFR at 1 year was the only independent predictor that remained statistically significant on multivariate analysis (hazard ratio =2.87; 95% confidence interval, 1.52-5.41).
Conclusions:
Severe renal dysfunction at 1 year was an independent predictor of long-term all-cause mortality in heart transplant patients.
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