Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation
Acute kidney injury (AKI) is a well-known risk factor for major adverse kidney events (MAKE) and major adverse cardiovascular events (MACE) in nontransplant settings. However, the association between AKI after liver transplantation (LT) and MACE/MAKE is not established. A retrospective cohort analys...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/11/3100 |
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| author | Yi-Chia Chan Cheng-Hsi Yeh Lung-Chih Li Chao-Long Chen Chih-Chi Wang Chih-Chi Lin Aldwin D. Ong Ting-Yu Chiou Chee-Chien Yong |
| author_facet | Yi-Chia Chan Cheng-Hsi Yeh Lung-Chih Li Chao-Long Chen Chih-Chi Wang Chih-Chi Lin Aldwin D. Ong Ting-Yu Chiou Chee-Chien Yong |
| author_sort | Yi-Chia Chan |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a well-known risk factor for major adverse kidney events (MAKE) and major adverse cardiovascular events (MACE) in nontransplant settings. However, the association between AKI after liver transplantation (LT) and MACE/MAKE is not established. A retrospective cohort analysis including 512 LT recipients was conducted. The incidence of post-LT AKI was 35.0% (<i>n</i> = 179). In total, 13 patients (2.5%) developed de novo coronary artery disease (CAD), 3 patients (0.6%) diagnosed with heart failure (HF), and 11 patients (2.1%) had stroke. The post-LT AKI group showed a higher incidence of CAD and HF than the no post-LT AKI group (4.5% versus 1.5%, <i>p</i> = 0.042; 1.7% versus 0%, <i>p</i> = 0.018; respectively), while there was no significant difference in the stroke events (2.8% versus 1.8%, <i>p</i> = 0.461). Through Cox regression analysis, history of cardiovascular disease (HR 6.51, 95% CI 2.43–17.46), post-LT AKI (HR 3.06, 95% CI 1.39–6.75), and pre-LT diabetes (HR 2.37, 95% CI 1.09–5.17) were identified as independent predictors of MACE; pre-LT chronic kidney disease (HR 9.54, 95% CI 3.49–26.10), pre-LT diabetes (HR 3.51, 95% CI 1.25–9.86), and post-LT AKI (HR 6.76, 95% CI 2.19–20.91) were risk factors for end-stage renal disease. Post-LT AKI is predictive for the development of MACE and MAKE. |
| first_indexed | 2024-03-10T01:11:33Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:11:33Z |
| publishDate | 2022-05-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-a8264161d43a41d792bb0276ef48e9ae2023-11-23T14:16:49ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011111310010.3390/jcm11113100Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver TransplantationYi-Chia Chan0Cheng-Hsi Yeh1Lung-Chih Li2Chao-Long Chen3Chih-Chi Wang4Chih-Chi Lin5Aldwin D. Ong6Ting-Yu Chiou7Chee-Chien Yong8Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Internal Medicine, Division of Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Internal Medicine, Division of Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanLiver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanAcute kidney injury (AKI) is a well-known risk factor for major adverse kidney events (MAKE) and major adverse cardiovascular events (MACE) in nontransplant settings. However, the association between AKI after liver transplantation (LT) and MACE/MAKE is not established. A retrospective cohort analysis including 512 LT recipients was conducted. The incidence of post-LT AKI was 35.0% (<i>n</i> = 179). In total, 13 patients (2.5%) developed de novo coronary artery disease (CAD), 3 patients (0.6%) diagnosed with heart failure (HF), and 11 patients (2.1%) had stroke. The post-LT AKI group showed a higher incidence of CAD and HF than the no post-LT AKI group (4.5% versus 1.5%, <i>p</i> = 0.042; 1.7% versus 0%, <i>p</i> = 0.018; respectively), while there was no significant difference in the stroke events (2.8% versus 1.8%, <i>p</i> = 0.461). Through Cox regression analysis, history of cardiovascular disease (HR 6.51, 95% CI 2.43–17.46), post-LT AKI (HR 3.06, 95% CI 1.39–6.75), and pre-LT diabetes (HR 2.37, 95% CI 1.09–5.17) were identified as independent predictors of MACE; pre-LT chronic kidney disease (HR 9.54, 95% CI 3.49–26.10), pre-LT diabetes (HR 3.51, 95% CI 1.25–9.86), and post-LT AKI (HR 6.76, 95% CI 2.19–20.91) were risk factors for end-stage renal disease. Post-LT AKI is predictive for the development of MACE and MAKE.https://www.mdpi.com/2077-0383/11/11/3100acute kidney injuryliver transplantationmajor adverse cardiovascular eventsmajor adverse kidney eventcardiovascular disease |
| spellingShingle | Yi-Chia Chan Cheng-Hsi Yeh Lung-Chih Li Chao-Long Chen Chih-Chi Wang Chih-Chi Lin Aldwin D. Ong Ting-Yu Chiou Chee-Chien Yong Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation Journal of Clinical Medicine acute kidney injury liver transplantation major adverse cardiovascular events major adverse kidney event cardiovascular disease |
| title | Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation |
| title_full | Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation |
| title_fullStr | Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation |
| title_full_unstemmed | Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation |
| title_short | Excess Risk of Major Adverse Cardiovascular and Kidney Events after Acute Kidney Injury following Living Donor Liver Transplantation |
| title_sort | excess risk of major adverse cardiovascular and kidney events after acute kidney injury following living donor liver transplantation |
| topic | acute kidney injury liver transplantation major adverse cardiovascular events major adverse kidney event cardiovascular disease |
| url | https://www.mdpi.com/2077-0383/11/11/3100 |
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