title: Acute kidney injury influences mortality in lung transplantation.
abstract: OBJECTIVE
  To evaluate the association between acute kidney injury (AKI) and long-term survival in lung transplant patients.
  
  
  METHODS
  Clinical data of 88 patients who underwent lung transplantation (LTx) were retrospectively analyzed at our institution from September 2002 to December 2011. Postoperative AKI was defined and divided into three groups based on creatinine criteria from the Acute Kidney Injury Net (AKIN) classification. A multivariable logistic regression model evaluated risk factors for AKI. Primary outcome was 5-year mortality. Risk adjusted multivariable COX proportional hazards regression examined the association of AKI with mortality.
  
  
  RESULTS
  A total of 47 (53.40%) patients developed AKI (27 with AKIN1, 20 with AKIN2-3) in the first week after LTx. Multivariate analysis showed pre-LT (pre-lung transplant) hypertension (OR 1.37 [0.06-2.68], p=0.041) and mechanical ventilation (OR 0.05 [0.01-0.09], p=0.022) were risk factors for postoperative AKI. Five-year survival rates in the non-AKI, AKIN1, and AKIN2-3 groups were 48.8%, 37.0%, 30.0%, respectively (p=0.041). Adjusted for age, sex, type and cause of LT, hypertension and diabetes, the hazard ratio for death was 1.481 ([1.040-2.107]) for AKI.
  
  
  CONCLUSIONS
  The occurrence of AKI after LTx is common. Severe AKI would increase long-term mortality risk. Several variables, including pre-LT hypertension and mechanical ventilation, are associated with AKI after LTx.
authors.affiliation: Department of Nephrology, Wuxi People's Hospital, the Affiliated Hospital of Nanjing Medical University , Jiangsu , China and.
authors.forename: Jing
authors.initials: J
authors.lastname: Xue
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Cai-Mei
authors.initials: CM
authors.lastname: Chen
authors.forename: Jing-Yu
authors.initials: JY
authors.lastname: Chen
authors.forename: Zhu-Xing
authors.initials: ZX
authors.lastname: Sun
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003404:Creatinine