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. 2019 Nov 1;6(4):108.
doi: 10.3390/medicines6040108.

Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Charat Thongprayoon  1 , Ploypin Lertjitbanjong  2 , Panupong Hansrivijit  3 , Anthony Crisafio  4 , Michael A Mao  5 , Kanramon Watthanasuntorn  6 , Narothama Reddy Aeddula  7 , Tarun Bathini  8 , Wisit Kaewput  9 , Wisit Cheungpasitporn  10
Affiliations

Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Charat Thongprayoon et al. Medicines (Basel). .

Abstract

Background: Acute kidney injury (AKI) is a common complication following solid-organ transplantation. However, the epidemiology of AKI and mortality risk of AKI among patients undergoing cardiac transplantation is not uniformly described. We conducted this study to assess the incidence of AKI and mortality risk of AKI in adult patients after cardiac transplantation. Methods: A systematic review of EMBASE, MEDLINE, and Cochrane Databases was performed until June 2019 to identify studies evaluating the incidence of AKI (by standard AKI definitions), AKI requiring renal replacement therapy (RRT), and mortality risk of AKI in patients undergoing cardiac transplantation. Pooled AKI incidence and mortality risk from the included studies were consolidated by random-effects model. The protocol for this study is registered with PROSPERO (no. CRD42019134577). Results: 27 cohort studies with 137,201 patients undergoing cardiac transplantation were identified. Pooled estimated incidence of AKI and AKI requiring RRT was 47.1% (95% CI: 37.6-56.7%) and 11.8% (95% CI: 7.2-18.8%), respectively. The pooled ORs of hospital mortality and/or 90-day mortality among patients undergoing cardiac transplantation with AKI and AKI requiring RRT were 3.46 (95% CI, 2.40-4.97) and 13.05 (95% CI, 6.89-24.70), respectively. The pooled ORs of 1-year mortality among patients with AKI and AKI requiring RRT were 2.26 (95% CI, 1.56-3.26) and 3.89 (95% CI, 2.49-6.08), respectively. Conclusion: Among patients undergoing cardiac transplantation, the incidence of AKI and severe AKI requiring RRT are 47.1% and 11.8%, respectively. AKI post cardiac transplantation is associated with reduced short term and 1-year patient survival.

Keywords: AKI; acute kidney injury; cardiac transplantation; epidemiology; heart transplantation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flowchart for the systematic review.
Figure 2
Figure 2
Forest plots of the included studies evaluating incidence of AKI among patients undergoing cardiac transplantation. A diamond data marker represents the overall rate from individual study (square data marker) and 95% CI.
Figure 3
Figure 3
Forest plots of the included studies assessing incidence rates of AKI requiring RRT among patients undergoing cardiac transplantation. A diamond data marker depicts the overall rate from each included study (square data marker) and 95% CI.
Figure 4
Figure 4
Forest plots of the included studies assessing (A) hospital mortality and/or 90-day mortality among patients undergoing cardiac transplantation with AKI and (B) hospital mortality and/or 90-day mortality among patients undergoing cardiac transplantation with AKI on RRT. A diamond data label serves as the overall rate from each included study (square data marker) and 95% CI.
See this image and copyright information in PMC

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