Ischaemic heart disease is a risk factor for renal failure after heart transplantation.
BACKGROUND
The improvement of a long-term outcomes of heart transplantation (HTx) has resulted in a new phenomenon; specifically, the development of renal dysfunction secondary to calcineurin inhibitor toxicity. This study was designed to assess the participation of risk factors in the development of renal dysfunction in HTx.


METHODS
Data from 310 patients undergoing HTx in our center between 1988-1998 with a post-operation survival period for minimum 5 years (n=155) were analyzed retrospectively. Study cohort was divided into two groups according to renal function estimated by serum creatinine in the fifth year (Group I n=72; serum creatinine > or = 150 micromol/l, Group II: n=83, serum creatinine < 150 micromol/l).


RESULTS
We noted that patients with serum creatinine > or = 150 micromol/l at 5 years post-HTx had renal function significantly worse as early as 1 month (p<0.01), and 1 year post-HTx (p<0.001). The risk for developing renal dysfunction after HTx was doubled in patients with a history of coronary artery disease (CAD), and 2.5 times higher in those with small body weight gain. End stage renal disease developed in 16 patients (10.3%) and renal transplantation was performed in 13 (8.4%) of them.


CONCLUSIONS
Our data documented that a history of CAD and limited weight gain is a major risk factor for development of renal dysfunction after HTx. Aggressive modification of risk factors for CAD may reduce the occurrence of this complication.
Hosková
Lenka
L
Viklický
Ondrej
O
Málek
Ivan
I
Podzimková
Mariana
M
Hegarová
Markéta
M
Pirk
Jan
J
Vítko
Stefan
S
Kautzner
Josef
J
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis