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Incidencia y factores de riesgo para la progresión de la lesión renal aguda a la enfermedad renal crónica después del
Liping Li1, Jinxuan Dai1,2, Yiqian Liu3
1Department of Anesthesiology, The Third Affiliated Hospital of SunYat-Sen University, Guangzhou City, Guangdong Province, China.
Resumen
Casi el 30% de los pacientes con trasplante de hígado desarrollan enfermedad renal crónica después de una lesión renal aguda. La diabetes preexistente, el cáncer y el deterioro de la función renal son factores de riesgo clave para esta progresión.
Área de la Ciencia:
- Nefrología
- Medicina del trasplante
- Epidemiología clínica
Sus antecedentes:
- La lesión renal aguda (IRA) después del trasplante de hígado puede conducir a la enfermedad renal crónica (ERC).
- La progresión de la ERC aumenta la mortalidad, las estadías hospitalarias y los costos de atención médica.
- La identificación de los factores de riesgo para la progresión de la IAC a la ERC es crucial para los resultados de los pacientes.
Objetivo del estudio:
- Investigar el pronóstico de la progresión de la IAC a ERC después del trasplante de hígado.
- Identificar los factores de riesgo independientes asociados con la progresión de la IAC a la ERC.
Principales métodos:
- Estudio de cohorte retrospectivo de 443 pacientes con IAC después de un trasplante de hígado.
- Clasificación en grupos de ERC y no ERC.
- Análisis de regresión logística multivariada para determinar los factores de riesgo.
Principales resultados:
- La IAC progresó a ERC en el 29,3% de los pacientes.
- El desarrollo de ERC se relacionó con una tasa de mortalidad al año significativamente mayor (4,6%).
- Los factores de riesgo independientes incluyeron diabetes preoperatoria, malignidad hepática, SCr elevado, transición/estadios de AKD y bajo eGFR; mayor riesgo de HCT y recuperación de AKD.
Conclusiones:
- La progresión de AKI a ERC es una preocupación significativa después del trasplante de hígado.
- Las condiciones preoperatorias y la función renal postoperatoria temprana son predictores críticos.
- La orientación hacia los factores de riesgo identificados puede mitigar el desarrollo de ERC y mejorar la supervivencia a largo plazo.
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