title: Risk factors associated with moderate-to-severe renal dysfunction among heart transplant patients: results from the CAPRI study.
abstract: The longer survival of patients with heart transplantation (HT) favors calcineurin inhibitor-related chronic kidney disease (CKD). It behoves to identify risk factors. At 14 Spanish centers, data on 1062 adult patients with HT (age 59.2 ± 12.3 yr, 82.5% men) were collected at routine follow-up examinations. Glomerular filtration rate, GFR, was estimated using the four-variable MDRD equation, and moderate-or-severe renal dysfunction (MSRD) was defined as K/DOQI stage 3 CKD or worse. Time since transplant ranged from one month to 22 yr (mean 6.7 yr). At assessment, 26.6% of patients were diabetic and 63.9% hypertensive; 53.9% were taking cyclosporine and 33.1% tacrolimus; and 61.4% had MSRD. Among patients on cyclosporine or tacrolimus at assessment, multivariate logistic regression identified male sex (OR 0.44), pre- and post-HT creatinine (2.73 and 3.13 per mg/dL), age at transplant (1.06 per yr), time since transplant (1.05 per yr), and tacrolimus (0.65) as independent positive or negative predictors of MSRD. It is concluded that female sex, pre- and one-month post-HT serum creatinine, age at transplant, time since transplant, and immunosuppression with cyclosporine rather than tacrolimus may all be risk factors for development of CKD ≥ stage 3 by patients with HT.
authors.affiliation: Hospital Universitario 12 De Octubre, Madrid, Spain. jdelgado.hdoc@salud.madrid.org
authors.forename: Juan F
authors.initials: JF
authors.lastname: Delgado
authors.forename: María G
authors.initials: MG
authors.lastname: Crespo-Leiro
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gómez-Sánchez
authors.forename: María J
authors.initials: MJ
authors.lastname: Paniagua
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Vílchez
authors.forename: José A
authors.initials: JA
authors.lastname: Vázquez de Prada
authors.forename: Juan
authors.initials: J
authors.lastname: Fernández-Yáñez
authors.forename: David
authors.initials: D
authors.lastname: Pascual
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: Beatriz
authors.initials: B
authors.lastname: Díaz
authors.forename: Eulalia
authors.initials: E
authors.lastname: Roig
authors.forename: Javier
authors.initials: J
authors.lastname: Segovia
authors.forename: Jose M
authors.initials: JM
authors.lastname: Arizón
authors.forename: Iris
authors.initials: I
authors.lastname: Garrido
authors.forename: Teresa
authors.initials: T
authors.lastname: Blasco
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.forename: Vicens
authors.initials: V
authors.lastname: Brossa
authors.forename: Nicolás
authors.initials: N
authors.lastname: Manito
authors.forename: Javier
authors.initials: J
authors.lastname: Muñiz
mesh_terms: D000293:Adolescent; D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000188:drug therapy*; D006085:Graft Survival; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine