caa a22 4500 445797061 CHVBK 20180317145129.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s10620-010-1529-2 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1529-2 Pre-transplant Kidney Function Predicts Chronic Kidney Disease After Liver Transplant: Meta-Analysis of Observational Studies [Elektronische Daten] [Fabrizio Fabrizi, Vivek Dixit, Paul Martin, Piergiorgio Messa] Background: Chronic kidney disease is a common problem in long-term survivors after liver transplantation. Several studies to clarify the risk factors for incidence of chronic kidney disease among liver transplant recipients, including preoperative kidney function, have yielded conflicting results. Aim: The aim of this study was to conduct a systematic review of the published medical literature on the impact of pre-transplant kidney function on the occurrence of chronic kidney disease after liver transplantation. Methods: Study-specific relative risks were weighted by the inverse of their variance to obtain fixed- and random-effects pooled estimates for incidence of chronic kidney disease across the published studies. The relative risk of chronic kidney disease after liver transplantation according to pre-transplant glomerular filtration rate was regarded as the most reliable outcome end-point. Results: We identified seven studies (38,036 unique liver transplant recipients). A stratified analysis including only studies provided with glomerular filtration rate at transplant reported that the summary estimate of relative risk and 95% confidence intervals (CIs) for developing chronic renal failure among liver transplant recipients with diminished renal function at transplant was 2.12 (95% CI, 1.01; 4.46) (random-effects model). The p value for study heterogeneity was significant (p=0.0001). Post-transplant chronic kidney disease shows impact on survival; the summary estimate for the adjusted relative risk of all-cause mortality with chronic kidney disease after liver transplant was 4.35 (95% confidence Intervals, 3.34; 5.66), p=0.0001 (random-effects model). Conclusions: An increased risk of chronic kidney disease frequently exists among liver transplant recipients with reduced renal function at transplant. The occurrence of chronic kidney disease after liver transplantation has a major impact on mortality. Additional studies are needed to understand better the natural history of chronic kidney disease among liver transplant recipients. Springer Science+Business Media, LLC, 2011 Liver transplantation nationallicence Chronic kidney disease nationallicence Incidence nationallicence MELD score nationallicence OLT : Orthotopic liver transplantation nationallicence CKD : Chronic kidney disease nationallicence LT : Liver transplantation nationallicence DM : Diabetes mellitus nationallicence aRR : Adjusted relative risk nationallicence CAD : Coronary artery disease nationallicence CIs : Confidence intervals nationallicence MELD : Model for end-stage liver disease nationallicence GFR : Glomerular filtration rate nationallicence ESRD : End-stage renal disease nationallicence TIPS : Transjugular intra-hepatic porto-systemic shunt nationallicence MDRD : Modification of diet in renal disease nationallicence MOOSE : Standard guidelines for meta-analyses of observational studies nationallicence ESLD : End-stage liver disease nationallicence HCV : Hepatitis C virus nationallicence Fabrizi Fabrizio Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, 20122, Milan, Italy aut Dixit Vivek Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA aut Martin Paul Division of Hepatology, School of Medicine, University of Miami, Miami, FL, USA aut Messa Piergiorgio Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, 20122, Milan, Italy aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1282-1289 0163-2116 56:5<1282 2011 56 10620 https://doi.org/10.1007/s10620-010-1529-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1529-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fabrizi Fabrizio Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, 20122, Milan, Italy aut NATIONALLICENCE 700 1- Dixit Vivek Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Martin Paul Division of Hepatology, School of Medicine, University of Miami, Miami, FL, USA aut NATIONALLICENCE 700 1- Messa Piergiorgio Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, 20122, Milan, Italy aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1282-1289 0163-2116 56:5<1282 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer