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Chronic kidney disease after liver transplantation for alcoholic liver disease


Mrzljak, Anna; Galešić Ljubanović, Danica; Bulimbašić, Stela; Borčić, Tina; Mihovilović, Karlo; Filipec-Kanižaj, Tajana; Čolić Cvrlje, Vesna; Naumovski Mihalić, Slavica; Katičić, Miroslava; Martinac, Krešimir; Knotek, Mladen
Chronic kidney disease after liver transplantation for alcoholic liver disease // EASL monothematic conference Alcoholic liver disease : Book of abstracts
Atena, Grčka, 2010. str. 121-121 (poster, međunarodna recenzija, sažetak, znanstveni)


Naslov
Chronic kidney disease after liver transplantation for alcoholic liver disease

Autori
Mrzljak, Anna ; Galešić Ljubanović, Danica ; Bulimbašić, Stela ; Borčić, Tina ; Mihovilović, Karlo ; Filipec-Kanižaj, Tajana ; Čolić Cvrlje, Vesna ; Naumovski Mihalić, Slavica ; Katičić, Miroslava ; Martinac, Krešimir ; Knotek, Mladen

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
EASL monothematic conference Alcoholic liver disease : Book of abstracts / - , 2010, 121-121

Skup
EASL monothematic conference Alcoholic liver disease

Mjesto i datum
Atena, Grčka, 10-12.12.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Chronic kideny disease ; liver transplantation

Sažetak
Chronic kidney disease (CKD) is a frequent complication after liver transplantation (LT) for alcoholic liver disease (ALD), therefore it is necessary to identify and affect predisposing factors. 99 ALD recipients without preexisting CKD transplanted in our centre between 2005. - 2010. were analyzed. CKD after LT was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1, 73m2 for at least three consecutive months using Modification in Renal Disease formula. Majority (84, 8%) of recipients were men, mean age 54, 38±7, 33 (range, 32 -73) years. Mean eGFR at LT was 75, 38±26, 85 ml/min/1, 73 m2. The mean eGFR deteriorated significantly following LT. However, the decline in the eGFR after LT positively correlated with the level of eGFR at LT, whereby the decline was more pronounced in patients with higher eGFR prior to the LT. Cumulative incidence of newly developed CKD at 12, 24, 36 and 48 months after LT was 56, 6%, 58, 5%, 61, 1 % and 61, 1%, respectively. Renal pathohistology, obtained from 20 patients at median of 13, 5 months (range, 3- 60) after LT, showed the following etiology of CKD: CNI nephrotoxicity (60, 0% of patients), primary glomerular disease (30, 0%) and hypertensive nephropathy(10, 0%). No correlation was established between the eGFR and the degree of interstitial fibrosis and tubular atrophy (IF/TA) in entire cohort with CKD (r=0, 185 p=0, 447), as well as in patients with CNI nephrotoxicity (r=-0, 014, p=0, 965). CNI nephrotoxicity is the leading cause of newly developed CKD after LT for ALD. The lack of correlation between eGFR and IF/TA indicates a significant functional component of kidney dysfunction. Kidney biopsy should be considered early in the diagnostic algorithm for the kidney dysfunction to enable proper etiological therapy before the development of irreversible histological changes in kidneys. Considering predominance of CNIs nephrotoxicity it is necessary to evaluate immunosuppressive protocols with lower CNI exposition.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti



POVEZANOST RADA


Projekt / tema
044-0000000-3356 - Imunološki nadzor u bolesnika s transplantiranim solidnim organom (Mladen Knotek, )
108-0000000-3114 - HELICOBAKTER PYLORI INFEKCIJA - EVOLUCIJA BOLESTI I NOVI TERAPIJSKI POSTUPCI (Miroslava Katičić, )
108-1081873-1893 - Prognostički faktori, dijagnostika i terapija hemoblastoza (Branimir Jakšić, )
198-0000000-3355 - Značaj morfoloških čimbenika u dijagnostici, terapiji i prognozi FSGS (Danica Galešić-Ljubanović, )

Ustanove
Medicinski fakultet, Zagreb