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Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality.

Publication ,  Journal Article
Rocha, PN; Rocha, AT; Palmer, SM; Davis, RD; Smith, SR
Published in: Am J Transplant
June 2005

The incidence, predictors and clinical significance of acute renal failure (ARF) after lung transplantation are not well described. We retrospectively collected data on 296 patients transplanted at our center between April 1992 and December 2000; follow-up was extended until December 2002. Patients were initially divided into two groups: ARF (doubling of baseline creatinine within 2 weeks after surgery) and NoARF. The ARF group was subdivided into ARFD (dialyzed) and ARFnD (not dialyzed). The incidence of ARF was 56% (166/296), but most cases were ARFnD (n = 143). Independent predictors of ARFD (n = 23) were: baseline GFR (OR 0.98, CI 0.96-0.99, p = 0.012), pulmonary diagnosis other than COPD (OR 6.80, CI 1.5-30.89, p = 0.013), mechanical ventilation > 1 d (OR 6.16, CI 1.70-22.24, p = 0.006) and parenteral amphotericin B use (OR 3.04, CI 1.03-8.98, p = 0.045). Both ARFnD and ARFD were associated with longer duration of mechanical ventilation, increased hospital stay and increased early mortality. One-year patient survival was 92.3%, 81.8% and 21.7% in the NoARF, ARFnD and ARFD groups, respectively (p < 0.0001). After controlling for important covariates, ARFD remained associated with an increased hazard of dying (HR 6.77, CI 4.00-11.44, p < 0.0001). In conclusion, ARF occurs commonly after lung transplantation and affects important clinical outcomes, especially when dialysis is required.

Duke Scholars

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

June 2005

Volume

5

Issue

6

Start / End Page

1469 / 1476

Location

United States

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Renal Dialysis
  • Prognosis
  • Predictive Value of Tests
  • Morbidity
  • Middle Aged
  • Male
  • Lung Transplantation
 

Citation

APA
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ICMJE
MLA
NLM
Rocha, P. N., Rocha, A. T., Palmer, S. M., Davis, R. D., & Smith, S. R. (2005). Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality. Am J Transplant, 5(6), 1469–1476. https://doi.org/10.1111/j.1600-6143.2005.00867.x
Rocha, Paulo N., Ana T. Rocha, Scott M. Palmer, R Duane Davis, and Stephen R. Smith. “Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality.Am J Transplant 5, no. 6 (June 2005): 1469–76. https://doi.org/10.1111/j.1600-6143.2005.00867.x.
Rocha PN, Rocha AT, Palmer SM, Davis RD, Smith SR. Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality. Am J Transplant. 2005 Jun;5(6):1469–76.
Rocha, Paulo N., et al. “Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality.Am J Transplant, vol. 5, no. 6, June 2005, pp. 1469–76. Pubmed, doi:10.1111/j.1600-6143.2005.00867.x.
Rocha PN, Rocha AT, Palmer SM, Davis RD, Smith SR. Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality. Am J Transplant. 2005 Jun;5(6):1469–1476.
Journal cover image

Published In

Am J Transplant

DOI

ISSN

1600-6135

Publication Date

June 2005

Volume

5

Issue

6

Start / End Page

1469 / 1476

Location

United States

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Renal Dialysis
  • Prognosis
  • Predictive Value of Tests
  • Morbidity
  • Middle Aged
  • Male
  • Lung Transplantation