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Chronic Kidney Disease After Liver Transplantation
Franco H Cabeza Rivera1, Beatrice P Concepcion2, Swee-Ling L Levea3
1Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL.
Advances in Kidney Disease and Health
|September 1, 2023
Summary
Chronic kidney disease (CKD) is common after liver transplants, increasing mortality risk. Managing risk factors like calcineurin inhibitors and comorbidities can slow CKD progression.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Chronic kidney disease (CKD) is a frequent complication in liver transplant recipients.
- CKD in this population is linked to a higher risk of mortality.
- Identified risk factors include perioperative issues, donor factors, and recipient-related conditions.
Purpose of the Study:
- To review the risk factors, progression, and management of CKD in liver transplant recipients.
- To highlight strategies for preventing and treating kidney dysfunction post-transplantation.
Main Methods:
- Review of identified risk factors for CKD development in liver transplant recipients.
- Analysis of CKD progression patterns.
- Discussion of management strategies applicable to liver transplant patients.
Main Results:
- CKD development is influenced by perioperative factors (e.g., acute kidney injury), donor factors (e.g., extended criteria grafts), and recipient factors (e.g., calcineurin inhibitors, metabolic syndrome, diabetes, obesity).
- CKD exhibits bimodal progression: an initial rapid phase and a subsequent gradual decline.
- Management involves addressing comorbidities and potentially minimizing calcineurin inhibitor use.
Conclusions:
- Standard CKD management strategies are applicable to liver transplant recipients.
- Minimizing calcineurin inhibitors can slow kidney dysfunction progression.
- Kidney transplantation offers survival benefits for patients with advanced CKD, with specific US allocation policies for early post-transplant development.
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