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Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Charat Thongprayoon1, Ploypin Lertjitbanjong2, Panupong Hansrivijit3

  • 1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MM 55905, USA. charat.thongprayoon@gmail.com.

Medicines (Basel, Switzerland)
|November 6, 2019
PubMed

Insights

Acute kidney injury (AKI) affects nearly half of cardiac transplant recipients, with 11.8% needing renal replacement therapy. This condition significantly increases short-term and one-year mortality risk in these patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Acute kidney injury (AKI) is a frequent complication after solid-organ transplantation.
  • The precise incidence and mortality impact of AKI in cardiac transplant recipients remain incompletely defined.

Purpose of the Study:

  • To determine the incidence of AKI in adult patients following cardiac transplantation.
  • To evaluate the mortality risk associated with AKI and AKI requiring renal replacement therapy (RRT) in this population.

Main Methods:

  • Systematic review of EMBASE, MEDLINE, and Cochrane Databases up to June 2019.
  • Inclusion of 27 cohort studies involving 137,201 cardiac transplant recipients.
  • Random-effects modeling to pool AKI incidence and mortality risk data.

Main Results:

  • Pooled incidence of AKI was 47.1%; incidence of AKI requiring RRT was 11.8%.
  • AKI was associated with a 3.46-fold increased risk of hospital/90-day mortality (OR: 3.46; 95% CI: 2.40-4.97).
  • AKI requiring RRT showed a significantly higher mortality risk (OR: 13.05; 95% CI: 6.89-24.70) and increased 1-year mortality (OR: 3.89; 95% CI: 2.49-6.08).

Conclusions:

  • Cardiac transplant recipients experience a high incidence of AKI (47.1%) and severe AKI requiring RRT (11.8%).
  • Post-transplant AKI is a significant independent predictor of reduced short-term and one-year survival.

Keywords:
AKIacute kidney injurycardiac transplantationepidemiologyheart transplantation

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