title: Evolution of native kidney function after pancreas transplantation alone.
abstract: BACKGROUND
  This study investigated changes in kidney function over time among a cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to December 2011.
  
  
  METHODS
  Ten of eighteen PTA patients bearing functioning grafts for at least 1 year were recruited for the analysis. Primary endpoints were changes in mean serum creatinine (SCr, mg/L) and mean estimated glomerular filtration rate (eGFR) using the 4-variable Levey-MDRD equation (mL/min/1.73 m(2)) comparing baseline (pretransplantation) to 6-month, 1-year, 3-year, and 5-year posttransplantation values. Mean follow-up time was 75.7 ± 20.5 months (range, 46-106.5).
  
  
  RESULTS
  Baseline eGFR was 89.3 ± 27.9 (range, 58-145). eGFR decreased to 75.7 ± 26.2, 71 ± 20.6, 66.5 ± 14.8, and 62.1 ± 11.2 at 6 months, 1, 3, and 5 years representing -15.2%, -20.5%, -15.8%, and -22.6% percentage decreases respectively (P < .05 for all pairwise comparisons). The Baseline SCr was 8.6 ± 2.3 mg/L (range, 5-13). SCr progressively increased to 10.1 ± 3, 10.5 ± 3.1, 10.9 ± 3.1, and 11.3 ± 1.7 at 6 months, 1, 3, and 5 years a 17.1%, 22%, 16.6%, and 19.9% increase respectively (P < .05 for all pairwise comparisons). One of ten, 2/8, and 3/7 patients displayed an eGFR <60 at transplantation versus 3 and 5 years thereafter, respectively. No patient developed a SCr > 25 mg/L or eGFR <30 or needed dialysis or kidney transplantation. Five of ten patients had micro-albuminuria or proteinuria before transplantation. Tacrolimus levels were within recommended therapeutic ranges over time.
  
  
  CONCLUSIONS
  Kidney function deteriorated significantly after PTA. Understanding of risk factors for the development of renal impairment is important to preserve kidney function and to select appropriate candidates for PTA.
authors.affiliation: Department of Abdominal Surgery and Transplantation, University Hospital, Liège, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Le Dinh
authors.forename: A
authors.initials: A
authors.lastname: Deroover
authors.forename: C
authors.initials: C
authors.lastname: Coimbra
authors.forename: L
authors.initials: L
authors.lastname: Weekers
authors.forename: J
authors.initials: J
authors.lastname: Léonet
authors.forename: M
authors.initials: M
authors.lastname: Meurisse
authors.forename: J P
authors.initials: JP
authors.lastname: Squifflet
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D003404:Creatinine; D016559:Tacrolimus