Трансплантология (Москва) (Dec 2018)
Kidney functional changes over time in liver recipients
Abstract
Background. Glomerular filtration rate is the main parameter characterizing the kidney functional condition. The evaluation of glomerular filtration rate is of significant importance, since in addition to an objective indicator of the kidney functional capacity, it is also a predictor of various pathological conditions, including cardiovascular complications.The aim of the study was to assess creatinine levels and glomerular filtration rates before and after orthotopic liver transplantation in clinical practice.Material and methods. A retrospective analysis of data obtained at different stages of the postoperative period in patients (n = 89) who underwent orthotopic liver transplantation in Research Institute – Regional Clinical Hospital № 1, Krasnodar, was performed. The creatinine level and glomerular filtration rate were studied before and at 6, 12, 24, and 36 months after liver transplantation, taking into account gender and age differences. Statistical analysis of the study results was made using Statistica 10 software.Results. The creatinine level was 82.9 ± 19.8 mmol/L before liver transplantation; creatinine increased by 20.4% (p = 0.004) at 6 months, by 24.8% (p = 0.00001), 24.4% (p = 0.0004), and 26.0% (p = 0.0005) at 12, 24 and 36 months after transplantation, respectively statistical significant in all cases. Compared to the baseline, the glomerular filtration rate decreased by 14.2% (p = 0.0005), 18.8% (p = 0.00001), 20.2% (p = 0.00003), and 22.6% (p = 0.00006) at 6, 12, 24, and 36 months, respectively statistical significant in all cases. Significant differences in kidney functional condition between men and women, as well as between the recipients younger and older 50 years were observed only at one year after transplantation.Conclusions. In the long-term postoperative period, there was an increase in creatinine level and a decrease in the level of glomerular filtration rate compared to the period before liver transplantation. At 6 months, two, and three years after liver transplantation, there were no significant differences in the studied liver functional parameters between the age groups or genders. Monitoring the glomerular filtration rate and preventing the progression of renal dysfunction in liver recipients
Keywords
