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Vol. 44. Issue 7.
Pages 353-359 (January 2008)
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Vol. 44. Issue 7.
Pages 353-359 (January 2008)
Original Articles
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Acute Renal Failure in Lung Transplantation: Incidence, Correlation With Subsequent Kidney Disease, and Prognostic Value
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Alejandro González Castroa,
Corresponding author
jandrol20475@hotmail.com

Correspondence: Dr A. Gonzalez Castro, Medicina Intensiva, Hospital Universitario Marques de Valdecilla, Avda. Valdecilla, s/n, 39008 Santander, Cantabria, Spain
, Javier Llorcab, Borja Suberviola Cañasa, Borja Fernández-Mireta, Felipe Zurbano, Eduardo Miñambresa
a Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
b División de Epidemiología y Biología Computacional, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, CIBER Epidemiología y Salud Pública (CiberEsp), Spain
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Objective

We studied the incidence of postoperative renal failure and its association with mortality in lung transplant patients in our hospital classified according to the severity of renal failure in the immediate postoperative period, and at 30 days, 6 months, and 1 year after transplantation.

Material and methods

For the period March 1997 through January 2006, 144 lung transplants were performed in our hospital. Six patients were lost to follow-up. Patients were assigned to 1 of the 5 Chronic Kidney Disease (CKD) classes according to the glomerular filtration rate on admission to the intensive care unit, and at 1 month, 6 months, and 12 months. Descriptive statistics were calculated for the sample. The relationship between the CKD classification and mortality was analyzed by calculating the odds ratio with a logistic regression model. The correlation between CKD classification on admission and at 1 month, 6 months, and 1 year after transplantation was analyzed using the Spearman correlation coefficient.

Results

Of the 144 patients analyzed, 52 patients were in CKD class 1, 63 in class 2, 19 in class 3, 2 in class 4, and 2 in class 5, according to the glomerular filtration rate. The correlation between mortality at 1 month and CKD classification on admission was not statistically significant (odds ratio, 1.11; 95% confidence interval, 0.42-3.11; P=.82) among patients with normal kidney function (CKD class 1) and those with some degree of renal failure (CKD classes 2-5). There was no correlation between CKD classification on admission and CKD classification at 1 month, 6 months, and 1 year although a significant positive correlation was found between CKD classification at 1 month and CKD classes at 6 months and 1 year.

Conclusions

We did not find any association between 1-month mortality and the degree of renal failure in the immediate postoperative period in lung transplant patients. There was a positive correlation between the degree of kidney failure at month and that observed 6 and 12 months after the procedure.

Key words:
Lung transplantation
Acute renal failure
Correlation
Mortality
Objetivo

Presentamos un análisis de incidencia de disfunción renal y mortalidad de los pacientes a quienes se practico un trasplante pulmonar en nuestro centro según el grado de insuficiencia renal que desarrollaron en el postoperatorio inmediato, a los 30 días, a los 6 meses y al año de realizado el trasplante.

Material y métodos

Durante el período definido (de marzo de 1997 a enero de 2006) se realizaron 144 trasplantes de pulmón en nuestro centro. Hubo 6 pérdidas en el seguimiento de los pacientes. Se clasificó a los pacientes en 5 grupos dependiendo del valor del filtrado glomerular en el momento de ingreso en la unidad de cuidados intensivos, al mes, a los 6 y 12 meses de realizado el trasplante, según la clasificación Chronic Kidney Disease (CKD). Se realizó un análisis estadístico descriptivo de la muestra. Se estudió la relación entre el CKD y la mortalidad, medida como odds ratios, mediante regresión logística. Se realizó un análisis de correlación entre el CKD al ingresar, al mes, a los 6 meses y al año de realizado el trasplante mediante el coeficiente de correlacion de Spearman.

Resultados

De los 144 pacientes analizados, se clasificó, atendiendo al filtrado glomerular, a 52 en el grupo I, a 63 en el grupo II, a 19 en el III, a 2 en el IV y a otros 2 en el V. La asociación entre mortalidad al mes y CKD al ingresar no evidenció significación estadistíca (odds ratio = 1,11; intervalo de confianza del 95%, 0,42-3,11; p = 0,82) entre los pacientes con función renal normal (CKD 1) y aquéllos con algún grado de insuficiencia renal (CKD 2-5). No se encontró correlación entre el CKD al ingreso y el CKD al mes, a los 6 meses y al año. Sin embargo, se halló una correlación positive (significativa) entre el CKD al mes y el CKD a los 6 meses y al año.

Conclusiones

No encontramos diferencias de asociación con la mortalidad al mes atendiendo al grado de insuficiencia renal en el postoperatorio inmediato de los pacientes con trasplante de pulmón. Existe una correlación positiva entre el grado de insuficiencia renal al mes y el observado a los 6 y 12 meses de realizado el trasplante.

Palabras clave:
Trasplante pulmonar
Insuficiencia renal aguda
Correlación
Mortalidad
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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