TORNA ALL’ELENCO

The increasing clinical burden of acute kidney injury in non renal solid organ transplant recipients: A 15 year retrospective analysis in Nephrology Dialysis Transplantation

2016
AO Cuneo

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (5)Vedi tutti...

Cantaluppi V
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Dipartimento di Medicina, Catania, Italy
Quercia AD
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Dipartimento di Medicina, Catania, Italy
Dellepiane S
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Dipartimento di Medicina, Catania, Italy

et alii...

Abstract

Introduction and Aims: Acute kidney injury (AKI) is a frequent complication in critically ill patients admitted to Intensive Care Units, often complicated by high mortality rates and progression toward end stage chronic kidney disease (CKD). Only a small number of studies evaluated AKI incidence in non renal solid organ transplant (NRSOT) recipients. The aims of the present study were: 1) a 15-year retrospective and monocentric analysis of AKI incidence in NRSOT; 2) to identify the clinical impact of AKI on outcome and progression toward CKD in this selected population. Methods: We retrospectively analyzed (2001-2015) the percentage of NRSOT in the whole AKI population treated by renal replacement therapies (RRTs) in our center. For each NRSOT recipient, we evaluated RIFLE and SOFA scores and the severity index ATN-ISS at the start of RRT. The percentage of AKI requiring dialysis in the whole NRSOT population and for single transplanted organ (liver, heart or lung graft) was also studied. Renal function was evaluated at the end of the observation period (30 days). Hemer-Lemeshow statistical test was performed. Results: In the period 2001-2015, we treated by RRT (prolonged intermittent daily hemofiltration of 10-12 hr or continuous veno-venous hemodiafiltration of 48-72 hr with prescribed dose of 30 ml/Kg/hr) 2756 critically ill patients with AKI for a total of 12416 RRT sessions performed. Among this population, 402/2756 (14.6%) were NRSOT recipients. In the study period, we treated by RRT 10.8 % of all patients subjected to liver transplantation, 27.5% of heart transplanted patients and 26.2% of lung transplanted patients. NRSOT patients' baseline characteristics were: mean age 59.2 yrs (SD 7.6), male gender 62.5%, mean serum creatinine 3.76 mg/dl (SD 1.34), mean number of organ failures 3.7 (SD 1.87) and mean ATN-ISS score 0.68 (SD 0.16). The prevalent cause of AKI in NRSOT patients was sepsis (52.5%), associated with high mortality, multiple organ failures

DOI : 10.1093/ndt/gfw147.6

Keywords

follow up; hemofiltration; continuous hemodiafiltration; intensive care unit; renal replacement therapy; male; liver transplantation; Sequential Organ Failure Assessment Score; gender; critically ill patient; creatinine blood level; kidney function; sepsis; liver; recipient; lung; mortality; heart; population; patient; human; solid; acute kidney failure; graft recipient; edetic acid; chronic kidney failure; therapy; survivor; hospital discharge; immunosuppressive treatment; multiple organ failure; dialysis;