Chronic kidney disease after orthotopic liver transplantation: impact of hepatitis C infection

Transplantation. 2011 Jun 15;91(11):1245-9. doi: 10.1097/TP.0b013e318218d5bd.

Abstract

Background: Hepatitis C virus (HCV) infection has been shown to be a potential risk factor for the development of chronic kidney disease in liver transplant recipients.

Methods: We performed a retrospective cohort study of 307 patients with and without HCV cirrhosis and preserved pretransplant renal function (serum creatinine<1.5 mg/dL pretransplantation) to assess the impact of HCV on the incidence of posttransplant chronic kidney disease. Kaplan-Meier analysis was performed for time to development of estimated glomerular filtration rate (eGFR) less than 30 mL/min, need for dialysis, and mortality.

Results: One hundred eighty-one patients were transplanted for HCV cirrhosis and 126 recipients had other causes of liver disease. Mean model for end-stage liver disease scores were 21.64 in the HCV group and 21.30 in the non-HCV group (P=0.58); 51% of patients in the HCV cohort had hepatocellular carcinoma compared with 27% in the non-HCV cohort (P<0.001). Mean pretransplant serum creatinine level was 0.89 mg/dL in both groups. At 3 years posttransplant, eGFR did not differ between the HCV and non-HCV cohorts (64.96 mL/min vs. 66.09 mL/min; P=0.71). A total of 14.4% of the patients with HCV achieved an eGFR less than 30 mL/min compared with 10.3% of the patients without HCV (P=0.13). There was no difference between the cohorts with respect to requirement for dialysis (P=0.73) or deaths (P=0.08), including those that were liver related (P=0.15).

Conclusions: Patients with HCV cirrhosis and normal preliver transplant renal function do not have worse posttransplant renal outcomes compared with those with other causes of liver disease.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Cohort Studies
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate
  • Hepatitis C / complications*
  • Humans
  • Kidney Diseases / etiology*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Creatinine