title: Does the development of chronic kidney disease and acute kidney injury affect the prognosis after living donor liver transplantation?
abstract: OBJECTIVE
  Chronic kidney disease (CKD) and acute kidney injury (AKI) have been discussed as complications following living donor liver transplantation (LDLT). The aim of this study was to clarify the relationships among CKD, AKI, and the prognosis after LDLT.
  
  
  METHODS
  This study included 118 patients who underwent LDLT in our department. A low eGFR (<60 mL/min/1.73 m(2) ) was regarded to indicate CKD. AKI 1 and AKI 2 were characterized by an increase in the serum creatinine level of 0.5 and 1.0 mg/dL, respectively, within one wk after LDLT. We investigated the risk factors for and the relevance of CKD and AKI on the prognosis.
  
  
  RESULTS
  AKI 1 was associated with sepsis and intra-operative bleeding (p = 0.0032, p = 0.001). AKI 2 was associated with sepsis and hepatitis C infection (p < 0.001, p = 0.027). A pre-operative eGFR of 60-89 and diabetes were the risk factors for the development of CKD in POY 2 (p = 0.018, p = 0.002). AKI 2, sepsis, and diabetes were the risk factors for the patient death within one yr after LDLT (p = 0.010, p = 0.002, p = 0.022). AKI 2 and sepsis were the risk factors for death within two yr after LDLT (p = 0.005, p = 0.018).
  
  
  CONCLUSIONS
  Recognizing the risk factors and careful management for preventing both AKI and CKD may improve the prognosis of patients following LDLT.
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Yusuke
authors: Y
authors: Inoue
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Akihiko
authors: A
authors: Soyama
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Mitsuhisa
authors: M
authors: Takatsuki
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Masaaki
authors: M
authors: Hidaka
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Ayaka
authors: A
authors: Kinoshita
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Koji
authors: K
authors: Natsuda
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Zhassulan
authors: Z
authors: Baimakhanov
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Tota
authors: T
authors: Kugiyama
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Tomohiko
authors: T
authors: Adachi
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Amane
authors: A
authors: Kitasato
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Tamotsu
authors: T
authors: Kuroki
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors: Susumu
authors: S
authors: Eguchi
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D007677:Kidney Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D055815:Young Adult
keywords: HCV; acute kidney injury; age; chronic kidney disease; diabetes; intra-operative bleeding; sepsis