title: Early predictors of renal dysfunction in cirrhotic patients after liver transplantation.
abstract: BACKGROUND
  Assessment of renal function 12 months after liver transplantation (LT) predicts chronic renal failure on long-term follow up.
  
  
  OBJECTIVE
  To evaluate pre- and post- LT factors associated with development of renal dysfunction (RD) in cirrhotic patients.
  
  
  METHODS
  Between June 2005 and June 2010, 104 cirrhotic patients were selected from 268 consecutively transplanted adult patients. RD was defined as a calculated glomerular filtration rate (cGFR) < 50 ml/min/1.73m2 by modification of diet in renal disease (MDRD), 12 months after LT.
  
  
  RESULTS
  Baseline pre-LT creatinine was 1.0 ± 0.7 mg/dL and cGFR was 64 ± 32.8 mL/min. At 12 month follow up, creatinine was 1.3 ± 0.6 mg/dL and cGFR was 47 ± 18 mL/min. The prevalence of RD was 55%. Variables related to RD on univariate analysis were age (P = 0.007), pre-L T GFR (P = 0.012) and 7th day post-L T GFR (P = 0.003). Risk factors associated with RD on multivariate stepwise regression analysis were patient age [Odds ratio (OR) 1.04 (95% confidence interval (CI) 0.99- 1.09, P = 0.06)] and 7 day post-LT GFR [OR 0.97 (95% CI 0.96-0.99, P = 0.013)]. ROC curve analysis for 7th day post-LT GFR was 0.71 (95% CI 0.61-0.81).
  
  
  CONCLUSIONS
  The 7th day post-LT GFR in cirrhotic patients may be a useful clinical tool to identify which patients might benefit from earlier nephroprotective immunosuppression.
authors.forename: Federico
authors.initials: F
authors.lastname: Piñero
authors.forename: Juan
authors.initials: J
authors.lastname: Bandi
authors.forename: Matías
authors.initials: M
authors.lastname: Tisi Baña
authors.forename: Paola
authors.initials: P
authors.lastname: Casciato
authors.forename: Alejandra
authors.initials: A
authors.lastname: Villamil
authors.forename: Omar
authors.initials: O
authors.lastname: Galdame
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibañés
authors.forename: Adrián
authors.initials: A
authors.lastname: Gadano
mesh_terms: D000328:Adult; D000368:Aged; D065095:Calcineurin Inhibitors / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016559:Tacrolimus / Q000009:adverse effects; D013997:Time Factors
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D016559:Tacrolimus