title: Chronic renal dysfunction in maintenance heart transplant patients: the ICEBERG study.
abstract: Chronic renal dysfunction (CRD) is a major complication after heart transplantation. We sought to describe the renal function over time, to assess the risk factors associated with CRD development, and to evaluate the clinical attitudes on diagnosis and treatment of CRD. A retrospective, cross-sectional, multicenter study was conducted in 13 outpatient clinics in Spain. A total of 244 heart recipients who survived more than 2 years after transplantation were included. Post-transplantation follow-up was 7.7 years (range: 2-22 years). CRD was diagnosed in 32.4% of patients at a mean of 3.3 years after transplantation. Serum creatinine increased 0.1 ± 0.2 mg/dL per year in CRD group compared with 0.0 ± 0.2 mg/dL per year in non-CRD group (P = .003) and glomerular filtration rate decreased -1.5 ± 4.3 mL/min/1.73 m(2) per year in CRD group versus -0.1 ± 4.8 mL/min/1.73 m(2) per year in non-CRD group (P = .027). After CRD diagnosis, major changes in immunosuppression based on calcineurin inhibitors reduction were instituted in 46.8% of patients. Multivariate model identified recipient age (P < .0001), female sex (P = .0398), and time since transplant (P < .0001) as predictors of CRD. In conclusion, the prevalence of CRD in long-term heart recipient survivors was quite high. CRD was associated with nonmodifiable factors (age, gender, and time since transplant).
authors: Hospital Marqués de Valdecilla, Santander, Spain. Electronic address: cargvf@humv.es.
authors: F
authors: F
authors: González-Vílchez
authors: Hospital Reina Sofía, Córdoba, Spain.
authors: J M
authors: JM
authors: Arizón
authors: Hospital Puerta de Hierro, Madrid, Spain.
authors: J
authors: J
authors: Segovia
authors: Hospital La Fe, Valencia, Spain.
authors: L
authors: L
authors: Almenar
authors: Hospital Juan Canalejo, A Coruña, Spain.
authors: M G
authors: MG
authors: Crespo-Leiro
authors: Hospital Gregorio Marañón, Madrid, Spain.
authors: J
authors: J
authors: Palomo
authors: Hospital Doce de Octubre, Madrid, Spain.
authors: J F
authors: JF
authors: Delgado
authors: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: S
authors: S
authors: Mirabet
authors: Clínica Universitaria de Navarra, Pamplona, Spain.
authors: G
authors: G
authors: Rábago
authors: Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors: F
authors: F
authors: Pérez-Villa
authors: Hospital Central de Asturias, Oviedo, Spain.
authors: B
authors: B
authors: Díaz
authors: Hospital Universitario Miguel Servet, Zaragoza, Spain.
authors: M L
authors: ML
authors: Sanz
authors: Hospital Virgen de la Arrixaca, Murcia, Spain.
authors: D
authors: D
authors: Pascual
authors: Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors: L
authors: L
authors: de la Fuente
authors: Medical Department Novartis, Madrid, Spain.
authors: G
authors: G
authors: Guinea
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine