“Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation
Abstract Background “Acute kidney dysfunction with no rejection” (ADNR) corresponds to acute kidney injury without histological evidence of acute rejection (AR) in kidney transplant recipients (KTR). The prognosis of ADNR is unknown. Methods From 2007 to 2015, we categorized KTR with for-cause kidne...
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| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-019-1444-5 |
| _version_ | 1811222710264528896 |
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| author | François Paquot Laurent Weekers Catherine Bonvoisin Hans Pottel François Jouret |
| author_facet | François Paquot Laurent Weekers Catherine Bonvoisin Hans Pottel François Jouret |
| author_sort | François Paquot |
| collection | DOAJ |
| description | Abstract Background “Acute kidney dysfunction with no rejection” (ADNR) corresponds to acute kidney injury without histological evidence of acute rejection (AR) in kidney transplant recipients (KTR). The prognosis of ADNR is unknown. Methods From 2007 to 2015, we categorized KTR with for-cause kidney biopsy within the first 12 months post kidney transplantation (KTx) into ADNR (n = 93) and biopsy-proven AR (n = 22). Controls (C, n = 135) included KTR with no ADNR or AR within the first 24 months post-KTx. A piecewise linear regression with a single fixed-knot at 12 months served to establish intercepts and slopes of MDRD-eGFR variations from 12 to 24 months. The percentage of KTR with ≥30% reduction of eGFR from 12 to 24 months was calculated as a surrogate marker of future graft loss. Results The median time for for-cause biopsy was 22 [10–70] and 13 [7–43] days for ADNR and AR, respectively. At 12 months, eGFR was significantly higher in C (57.6 ± 14.9 mL/min/1.73m2) vs. ADNR (43.5 ± 15.4 mL/min/1.73m2, p < 0.0001) and vs. AR (46.5 ± 15.2 mL/min/1.73m2, p < 0.0065). The proportion of KTR with ≥30% reduction in eGFR from 12 to 24 months reached 16.3% in C vs. 29.9% in ADNR (p = 0.02) and vs. 15% in AR (not significant). Conclusions ADNR is associated with poor outcomes within 2 years post-KTx. |
| first_indexed | 2024-04-12T08:19:38Z |
| format | Article |
| id | doaj.art-3593f551b7404be281ab665cbe75f7ed |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-12T08:19:38Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-3593f551b7404be281ab665cbe75f7ed2022-12-22T03:40:37ZengBMCBMC Nephrology1471-23692019-07-012011710.1186/s12882-019-1444-5“Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantationFrançois Paquot0Laurent Weekers1Catherine Bonvoisin2Hans Pottel3François Jouret4Division of Nephrology, Department of Internal Medicine, University of Liège HospitalDivision of Nephrology, Department of Internal Medicine, University of Liège HospitalDivision of Nephrology, Department of Internal Medicine, University of Liège HospitalKU Leuven Kulak, Department of Public Health and Primary Care, University of LeuvenDivision of Nephrology, Department of Internal Medicine, University of Liège HospitalAbstract Background “Acute kidney dysfunction with no rejection” (ADNR) corresponds to acute kidney injury without histological evidence of acute rejection (AR) in kidney transplant recipients (KTR). The prognosis of ADNR is unknown. Methods From 2007 to 2015, we categorized KTR with for-cause kidney biopsy within the first 12 months post kidney transplantation (KTx) into ADNR (n = 93) and biopsy-proven AR (n = 22). Controls (C, n = 135) included KTR with no ADNR or AR within the first 24 months post-KTx. A piecewise linear regression with a single fixed-knot at 12 months served to establish intercepts and slopes of MDRD-eGFR variations from 12 to 24 months. The percentage of KTR with ≥30% reduction of eGFR from 12 to 24 months was calculated as a surrogate marker of future graft loss. Results The median time for for-cause biopsy was 22 [10–70] and 13 [7–43] days for ADNR and AR, respectively. At 12 months, eGFR was significantly higher in C (57.6 ± 14.9 mL/min/1.73m2) vs. ADNR (43.5 ± 15.4 mL/min/1.73m2, p < 0.0001) and vs. AR (46.5 ± 15.2 mL/min/1.73m2, p < 0.0065). The proportion of KTR with ≥30% reduction in eGFR from 12 to 24 months reached 16.3% in C vs. 29.9% in ADNR (p = 0.02) and vs. 15% in AR (not significant). Conclusions ADNR is associated with poor outcomes within 2 years post-KTx.http://link.springer.com/article/10.1186/s12882-019-1444-5Acute kidney dysfunction with no rejection (ADNR)Kidney transplant recipients (KTR)Estimated glomerular filtration rate (eGFR)Acute rejection (AR)Outcomes |
| spellingShingle | François Paquot Laurent Weekers Catherine Bonvoisin Hans Pottel François Jouret “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation BMC Nephrology Acute kidney dysfunction with no rejection (ADNR) Kidney transplant recipients (KTR) Estimated glomerular filtration rate (eGFR) Acute rejection (AR) Outcomes |
| title | “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation |
| title_full | “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation |
| title_fullStr | “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation |
| title_full_unstemmed | “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation |
| title_short | “Acute kidney dysfunction with no rejection” is associated with poor renal outcomes at 2 years post kidney transplantation |
| title_sort | acute kidney dysfunction with no rejection is associated with poor renal outcomes at 2 years post kidney transplantation |
| topic | Acute kidney dysfunction with no rejection (ADNR) Kidney transplant recipients (KTR) Estimated glomerular filtration rate (eGFR) Acute rejection (AR) Outcomes |
| url | http://link.springer.com/article/10.1186/s12882-019-1444-5 |
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