Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment
Background: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. Methods: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrosp...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2013-12-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211913213000661 |
| _version_ | 1819175103930302464 |
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| author | Jong Hoon Lee Yul Hee Cho Seung Jee Ryu Sin Seung Kim Youn Hee Lee In-Ae Jang Bum Soon Choi Jong Young Choi Dong Goo Kim Yeong Jin Choi Chul Woo Yang Byung Ha Chung |
| author_facet | Jong Hoon Lee Yul Hee Cho Seung Jee Ryu Sin Seung Kim Youn Hee Lee In-Ae Jang Bum Soon Choi Jong Young Choi Dong Goo Kim Yeong Jin Choi Chul Woo Yang Byung Ha Chung |
| author_sort | Jong Hoon Lee |
| collection | DOAJ |
| description | Background: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment.
Methods: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy.
Results: The biopsies were performed at a median of 24.5 months (range, 3–73 months) after liver transplantation. The serum creatinine level was 1.81±0.5 mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN (n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%). Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%, and 80% of cases, respectively, and mesangial proliferation was detected in 40% of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease.
Conclusion: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes. |
| first_indexed | 2024-12-22T20:49:33Z |
| format | Article |
| id | doaj.art-a110a35d21c944b5bede4687f1c42f56 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 |
| language | English |
| last_indexed | 2024-12-22T20:49:33Z |
| publishDate | 2013-12-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-a110a35d21c944b5bede4687f1c42f562022-12-21T18:13:07ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322013-12-0132415315710.1016/j.krcp.2013.08.002Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairmentJong Hoon Lee0Yul Hee Cho1Seung Jee Ryu2Sin Seung Kim3Youn Hee Lee4In-Ae Jang5Bum Soon Choi6Jong Young Choi7Dong Goo Kim8Yeong Jin Choi9Chul Woo Yang10Byung Ha Chung11Division of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDepartment of Hospital Pathology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Nephrology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. Methods: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy. Results: The biopsies were performed at a median of 24.5 months (range, 3–73 months) after liver transplantation. The serum creatinine level was 1.81±0.5 mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN (n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%). Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%, and 80% of cases, respectively, and mesangial proliferation was detected in 40% of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease. Conclusion: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.http://www.sciencedirect.com/science/article/pii/S2211913213000661Calcineurin inhibitorChronic kidney diseaseKidney biopsyLiver transplantation |
| spellingShingle | Jong Hoon Lee Yul Hee Cho Seung Jee Ryu Sin Seung Kim Youn Hee Lee In-Ae Jang Bum Soon Choi Jong Young Choi Dong Goo Kim Yeong Jin Choi Chul Woo Yang Byung Ha Chung Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment Kidney Research and Clinical Practice Calcineurin inhibitor Chronic kidney disease Kidney biopsy Liver transplantation |
| title | Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| title_full | Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| title_fullStr | Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| title_full_unstemmed | Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| title_short | Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| title_sort | clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment |
| topic | Calcineurin inhibitor Chronic kidney disease Kidney biopsy Liver transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2211913213000661 |
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