[Acute renal failure in lung transplantation: incidence, correlation with subsequent kidney disease, and prognostic value].
OBJECTIVE
We studied the incidence of postoperative renal failure and its association with mortality in lung transplant patients in our hospital classified according to the severity of renal failure in the immediate postoperative period, and at 30 days, 6 months, and 1 year after transplantation.


METHODS
For the period March 1997 through January 2006, 144 lung transplants were performed in our hospital. Six patients were lost to follow-up. Patients were assigned to 1 of the 5 Chronic Kidney Disease (CKD) classes according to the glomerular filtration rate on admission to the intensive care unit, and at 1 month, 6 months, and 12 months. Descriptive statistics were calculated for the sample. The relationship between the CKD classification and mortality was analyzed by calculating the odds ratio with a logistic regression model. The correlation between CKD classification on admission and at 1 month, 6 months, and 1 year after transplantation was analyzed using the Spearman correlation coefficient.


RESULTS
Of the 144 patients analyzed, 52 patients were in CKD class 1, 63 in class 2, 19 in class 3, 2 in class 4, and 2 in class 5, according to the glomerular filtration rate. The correlation between mortality at 1 month and CKD classification on admission was not statistically significant (odds ratio, 1.11; 95% confidence interval, 0.42-3.11; P=.82) among patients with normal kidney function (CKD class 1) and those with some degree of renal failure (CKD classes 2-5). There was no correlation between CKD classification on admission and CKD classification at 1 month, 6 months, and 1 year although a significant positive correlation was found between CKD classification at 1 month and CKD classes at 6 months and 1 year.


CONCLUSIONS
We did not find any association between 1-month mortality and the degree of renal failure in the immediate postoperative period in lung transplant patients. There was a positive correlation between the degree of kidney failure at 1 month and that observed 6 and 12 months after the procedure.
González Castro
Alejandro
A
Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. jandro120475@hotmail.com
Llorca
Javier
J
Suberviola Cañas
Borja
B
Fernández-Miret
Borja
B
Zurbano
Felipe
F
Miñambres
Eduardo
E
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors