title: Post-liver transplant acute renal failure: factors predicting development of end-stage renal disease.
abstract: BACKGROUND
  Acute renal failure (ARF) occurs in 5-50% of patients undergoing orthotopic liver transplantation (OLT). The aim of this study was to determine factors that might predict the development of end stage renal disease (ESRD) in patients who had ARF after OLT.
  
  
  METHODS
  We studied all OLT recipients between 9/1/1988 through 12/31/2000.
  
  
  RESULTS
  A total of 1602 patients underwent OLT during the study period. About 350 patients (22%) developed ARF requiring dialysis post-operatively. One hundred and twenty-three (39.8%) died within a year after OLT. Median follow up was 5.8 yr (range 1-12 yr). Forty-three patients (23%) developed ESRD over median of 3.79 yr (range 1-8 yr). Multivariate logistic regression analysis revealed creatinine levels > 1.7 mg/dL at 1 yr (p < 0.001), cyclosporine as immunosuppression (p = 0.026), and the presence of diabetes pre-OLT (p < 0.001) to be associated with the development of ESRD. The development of ESRD did not decrease patient survival (p = 0.111). ESRD patients who received subsequent kidney transplantation had significantly improved survival rates (p = 0.005).
  
  
  CONCLUSIONS
  Serum creatinine levels at 1 yr, cyclosporine as immunosuppression, and the presence of diabetes pre-OLT are independent predictive factors for the development of ESRD. ESRD patients who received kidney transplantation had higher 10-yr survival rates when compared with patients maintained on dialysis.
authors.affiliation: The Recanat/Miller Transplantation Institute, The Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
authors.forename: Anil S
authors.initials: AS
authors.lastname: Paramesh
authors.forename: Sasan
authors.initials: S
authors.lastname: Roayaie
authors.forename: Yvette
authors.initials: Y
authors.lastname: Doan
authors.forename: Myron E
authors.initials: ME
authors.lastname: Schwartz
authors.forename: Sukru
authors.initials: S
authors.lastname: Emre
authors.forename: Thomas
authors.initials: T
authors.lastname: Fishbein
authors.forename: Sander
authors.initials: S
authors.lastname: Florman
authors.forename: Gabriel E
authors.initials: GE
authors.lastname: Gondolesi
authors.forename: Nancy
authors.initials: N
authors.lastname: Krieger
authors.forename: Scott
authors.initials: S
authors.lastname: Ames
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Bromberg
authors.forename: Enver
authors.initials: E
authors.lastname: Akalin
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology*; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D007677:Kidney Function Tests; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine