Predictors of chronic kidney disease in long-term survivors of lung and heart-lung transplantation

Am J Transplant. 2006 Sep;6(9):2157-63. doi: 10.1111/j.1600-6143.2006.01458.x. Epub 2006 Jul 6.


Renal insufficiency is common after non-renal organ transplants. The predictors of long-term renal outcomes are not well established. A total of 219 lung and heart-lung transplant recipients surviving more than 6 months after transplantation were studied to determine predictors of time to doubling of serum creatinine and end-stage kidney disease (ESKD) with death as a competing risk. Median follow-up was 79 months (range 9-222 months). Baseline estimated glomerular filtration rate (GFR) was 96.3+/-34.5 mL/min/1.73 m2. One hundred twenty-two recipients (55%) doubled their serum creatinine, 16 (7.3%) progressed to ESKD and 143 (65%) died. The majority of recipients who survived >6 years had a GFR<60 mL/min at both 1 and 7 years. Most of the loss of renal function occurred in the first year post-transplant. Older age at transplant, lower GFR at 1 month and cyclosporine use in the first 6 months predicted shorter time to doubling of serum creatinine when death was handled as a competing risk. Based on this prevalence data and using GFR decay and death as study endpoints, we offer sample size estimates for a prospective, interventional trial that is aimed at slowing or preventing the progression of kidney disease.

Publication types

  • Comparative Study

MeSH terms

  • Creatinine / blood
  • Cyclosporine / therapeutic use
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects
  • Glomerular Filtration Rate / physiology
  • Graft Rejection / prevention & control
  • Heart-Lung Transplantation*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / drug therapy
  • Kidney Failure, Chronic / etiology*
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survivors
  • Time Factors
  • Transplantation, Homologous


  • Immunosuppressive Agents
  • Cyclosporine
  • Creatinine