Sana Shehzad

Abstract:

Chronic kidney disease (CKD) remains one of the most common complications in lung transplant (LTx) recipients post transplantation. The underlying etiologies and risk factors leading to CKD in these patients have not been clearly defined. We conducted a multicenter, retrospective cohort study to investigate the characteristics, incidence, and risk factors of CKD post LTx. Patients that received a LTx between 2014-2019 at Massachusetts General Hospital or Brigham and Women’s Hospital were included. Patient data were retrieved at baseline and at various time points post transplantation. We used the KDIGO criteria to diagnose CKD and acute kidney injuries (AKI). At present, 176 LTx recipients have been included. The cumulative incidence of CKD experienced a striking increase especially within the first-year post-transplant and continued to increase to 78% at the 5-year mark [95% CI: 0.71-0.85] (Figure 1a). LTx patients with CKD had a higher median age at transplantation in comparison to the non-CKD cohort (p < 0.0001). CKD patients also had a higher baseline serum creatinine prior to LTx [0.80 mg/dL versus 0.74 mg/dL in the non-CKD cohort (p = 0.03)]. Moreover, we identified AKI as a clear risk factor for CKD in LTx recipients. 460 AKI’s were recorded overall – of these 371 AKI’s occurred in the CKD cohort. In the CKD cohort (n = 124) there were 371 cases of AKI observed. In comparison, the non-CKD cohort (n = 52) had 89 instances of AKI recorded. It is then crucial to increase focus on kidney injury post LTx to contend CKD.