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. 2013 Jan;8(1):19-25.
doi: 10.2215/CJN.04800512. Epub 2012 Oct 4.

Recovery from AKI and short- and long-term outcomes after lung transplantation

Edgard Wehbe  1 , Andra E Duncan, Gohar Dar, Marie Budev, Brian Stephany
Affiliations

Recovery from AKI and short- and long-term outcomes after lung transplantation

Edgard Wehbe et al. Clin J Am Soc Nephrol. 2013 Jan.

Abstract

Background and objectives: Patients with AKI after lung transplantation are at increased risk for CKD and death. Whether patients who completely recover from AKI have improved long-term outcome compared with patients who do not completely recover remains unknown.

Design, setting, participants, & measurements: This study retrospectively evaluated data on 657 patients who underwent lung transplantation from 1997 to 2009. Outcomes analyzed were the incidence of renal recovery after AKI and the association of this recovery with short- and long-term mortality. AKI was defined by an absolute increase in serum creatinine of ≥0.3 mg/dl or a percent increase in serum creatinine of ≥50% from baseline at any time during the first 2 weeks after transplantation.

Results: Four hundred twenty-four (65%) patients experienced AKI in the first 2 weeks after transplantation. Of these patients, complete renal recovery occurred in 142 (33%) patients. The incidence of in-hospital complications was similar between patients who recovered renal function and patients without recovery. At 1 year, the cumulative incidence of CKD was 14% and 22% (P=0.10) and patient survival rate was 81% and 76% (P=0.20) in patients with complete recovery from AKI and patients without recovery, respectively. Patients with completely recovered AKI had similar risk-adjusted long-term mortality compared with patients who did not recover (hazard ratio [95% confidence interval]=1.42 [1.15-2.05] versus 1.53 [1.01-2.00]).

Conclusions: Patients who recover completely from early AKI after lung transplantation have a similar risk for CKD and long-term mortality compared with patients who do not recover.

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Figures

Figure 1.
Figure 1.
The cumulative incidence of CKD after lung transplantation was not different in patients with recovery or no recovery from AKI.
Figure 2.
Figure 2.
Long-term mortality after lung transplantation was similar in patients with recovery or no recovery from AKI.
See this image and copyright information in PMC

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