Evaluation of Renal Function in Patients Undergoing Lung Transplantation

Area of Science:

• Nephrology
• Transplantation Surgery
• Pulmonology

Background:

• Acute kidney injury and chronic kidney failure are significant complications following lung transplantation.
• Glomerular filtration rate (GFR) is a key marker for assessing kidney function.
• Several equations exist to estimate GFR (eGFR), but their comparative accuracy in lung transplant recipients is unclear.

Purpose of the Study:

• To compare the predictive accuracy of three common eGFR equations (Cockcroft-Gault, MDRD, CKD-EPI) for acute and chronic kidney disease after lung transplantation.
• To identify the most reliable eGFR equation for preoperative risk assessment in lung transplant candidates.

Main Methods:

• Retrospective analysis of 22 lung transplant recipients (2010-2015).
• Preoperative eGFR was calculated using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and CKD-EPI equations.
• eGFR was recalculated at 1, 3, and 6 months post-transplant for 20 patients.

Main Results:

• MDRD and CKD-EPI identified more patients with preoperative reduced eGFR (36.3%) compared to CG (27.2%).
• Five patients (22.7%) developed perioperative acute renal failure requiring dialysis; four had higher preoperative CG eGFR.
• CKD-EPI eGFR values demonstrated greater predictability for acute kidney injury (AKI).

Conclusions:

• Preoperative eGFR assessment using MDRD and CKD-EPI equations shows better correlation with acute renal failure prediction post-lung transplant compared to the CG equation.
• The three eGFR equations demonstrated comparable performance in predicting chronic kidney disease in this cohort.