Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study

Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who...

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Autores principales:	Junseok Jeon, Hyejeong Park, Youngha Kim, Danbee Kang, Jung Eun Lee, Wooseong Huh, Eliseo Guallar, Juhee Cho, Hye Ryoun Jang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic kidney disease end-stage kidney disease heart transplantation nationwide cohort renal outcome Medicine R
Acceso en línea:	https://doaj.org/article/b6c9f5e69246434c8dce3fe3d415ae2b
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spelling	oai:doaj.org-article:b6c9f5e69246434c8dce3fe3d415ae2b2021-11-11T17:44:06ZPrognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study10.3390/jcm102151102077-0383https://doaj.org/article/b6c9f5e69246434c8dce3fe3d415ae2b2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5110https://doaj.org/toc/2077-0383Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who received HT between 2008 and 2016 and survived until discharge after HT were analyzed. The median (interquartile range) age was 52 (40–60) years, and 68.1% were male. Perioperative renal replacement therapy (RRT) was performed in 27.8% of patients. During 2.8 years of median followup, end-stage kidney disease (ESKD) developed in 12 patients (1.8%). In a fully adjusted model, RRT > 3 weeks, the use of inotropes/vasopressors and non-use of ACEi/ARB were associated with ESKD. Preexisting renal disease tended to be associated with ESKD. Among the 561 patients without preexisting CKD, 104 (18.5%) developed chronic kidney disease (CKD). Age, extracorporeal membrane oxygenation, and RRT were associated with the development of CKD after HT. Our nationwide cohort study demonstrated that perioperative RRT was a predictor of poor renal outcomes after HT. These results suggest that an active renoprotective strategy is required during the perioperative period.Junseok JeonHyejeong ParkYoungha KimDanbee KangJung Eun LeeWooseong HuhEliseo GuallarJuhee ChoHye Ryoun JangMDPI AGarticlechronic kidney diseaseend-stage kidney diseaseheart transplantationnationwide cohortrenal outcomeMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5110, p 5110 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic kidney disease end-stage kidney disease heart transplantation nationwide cohort renal outcome Medicine R
spellingShingle	chronic kidney disease end-stage kidney disease heart transplantation nationwide cohort renal outcome Medicine R Junseok Jeon Hyejeong Park Youngha Kim Danbee Kang Jung Eun Lee Wooseong Huh Eliseo Guallar Juhee Cho Hye Ryoun Jang Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
description	Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who received HT between 2008 and 2016 and survived until discharge after HT were analyzed. The median (interquartile range) age was 52 (40–60) years, and 68.1% were male. Perioperative renal replacement therapy (RRT) was performed in 27.8% of patients. During 2.8 years of median followup, end-stage kidney disease (ESKD) developed in 12 patients (1.8%). In a fully adjusted model, RRT > 3 weeks, the use of inotropes/vasopressors and non-use of ACEi/ARB were associated with ESKD. Preexisting renal disease tended to be associated with ESKD. Among the 561 patients without preexisting CKD, 104 (18.5%) developed chronic kidney disease (CKD). Age, extracorporeal membrane oxygenation, and RRT were associated with the development of CKD after HT. Our nationwide cohort study demonstrated that perioperative RRT was a predictor of poor renal outcomes after HT. These results suggest that an active renoprotective strategy is required during the perioperative period.
format	article
author	Junseok Jeon Hyejeong Park Youngha Kim Danbee Kang Jung Eun Lee Wooseong Huh Eliseo Guallar Juhee Cho Hye Ryoun Jang
author_facet	Junseok Jeon Hyejeong Park Youngha Kim Danbee Kang Jung Eun Lee Wooseong Huh Eliseo Guallar Juhee Cho Hye Ryoun Jang
author_sort	Junseok Jeon
title	Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_short	Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_full	Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_fullStr	Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_full_unstemmed	Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study
title_sort	prognostic factors of renal outcomes after heart transplantation: a nationwide retrospective study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b6c9f5e69246434c8dce3fe3d415ae2b
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Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study

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