Original Articles
Acute Renal Failure in Lung Transplantation: Incidence, Correlation With Subsequent Kidney Disease, and Prognostic Value
Alejandro González Castroa,
, Javier Llorcab, Borja Suberviola Cañasa, Borja Fernández-Mireta, Felipe Zurbano, Eduardo Miñambresa
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
Correspondence: Dr A. Gonzalez Castro, Medicina Intensiva, Hospital Universitario Marques de Valdecilla, Avda. Valdecilla, s/n, 39008 Santander, Cantabria, Spain
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"Alejandro González Castro, Javier Llorca, Borja Suberviola Cañas, Borja Fernández-Miret, Felipe Zurbano, Eduardo Miñambres" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Alejandro González" "apellidos" => "Castro" "email" => array:1 [ 0 => "jandrol20475@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Javier" "apellidos" => "Llorca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Borja Suberviola" "apellidos" => "Cañas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Borja" "apellidos" => "Fernández-Miret" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:2 [ "nombre" => "Felipe" "apellidos" => "Zurbano" ] 5 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Miñambres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "División de Epidemiología y Biología Computacional, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, CIBER Epidemiología y Salud Pública (CiberEsp), Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr A. Gonzalez Castro, Medicina Intensiva, Hospital Universitario Marques de Valdecilla, Avda. Valdecilla, s/n, 39008 Santander, Cantabria, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-03-27" "fechaAceptado" => "2008-01-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155304" "palabras" => array:4 [ 0 => "Lung transplantation" 1 => "Acute renal failure" 2 => "Correlation" 3 => "Mortality" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155305" "palabras" => array:4 [ 0 => "Trasplante pulmonar" 1 => "Insuficiencia renal aguda" 2 => "Correlación" 3 => "Mortalidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">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; <span class="elsevierStyleItalic">P</span>=.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.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">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 <span class="elsevierStyleItalic">odds ratios,</span> 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.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">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 <span class="elsevierStyleItalic">(odds ratio =</span> 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.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización del trasplante pulmonar en España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "JM Borro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2005" "volumen" => "41" "paginaInicial" => "457" "paginaFinal" => "467" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16117951" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications, patient selection and timing of referral for lung transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "AR Glanville" 1 => "M Estenne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "22" "paginaInicial" => "845" "paginaFinal" => "852" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14621095" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indicaciones del trasplante pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "MC Carreno Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2001" "volumen" => "201" "paginaInicial" => "396" "paginaFinal" => "397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11594133" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung and heartlung transplantation. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 31 | 17 | 48 |
| 2024 September | 25 | 15 | 40 |
| 2024 August | 42 | 32 | 74 |
| 2024 July | 23 | 27 | 50 |
| 2024 June | 35 | 19 | 54 |
| 2024 May | 39 | 30 | 69 |
| 2024 April | 19 | 20 | 39 |
| 2024 March | 17 | 14 | 31 |
| 2024 February | 21 | 25 | 46 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 20 | 19 | 39 |
| 2023 January | 20 | 37 | 57 |
| 2022 December | 25 | 49 | 74 |
| 2022 November | 31 | 20 | 51 |
| 2022 October | 22 | 38 | 60 |
| 2022 September | 20 | 26 | 46 |
| 2022 August | 18 | 31 | 49 |
| 2022 July | 22 | 42 | 64 |
| 2022 June | 18 | 35 | 53 |
| 2022 May | 18 | 22 | 40 |
| 2022 April | 17 | 35 | 52 |
| 2022 March | 17 | 34 | 51 |
| 2022 February | 22 | 22 | 44 |
| 2022 January | 17 | 29 | 46 |
| 2021 December | 20 | 45 | 65 |
| 2021 November | 25 | 50 | 75 |
| 2021 October | 29 | 52 | 81 |
| 2021 September | 19 | 54 | 73 |
| 2021 August | 14 | 37 | 51 |
| 2021 July | 12 | 36 | 48 |
| 2021 June | 11 | 22 | 33 |
| 2021 May | 11 | 34 | 45 |
| 2021 April | 30 | 90 | 120 |
| 2021 March | 14 | 20 | 34 |
| 2021 February | 15 | 19 | 34 |
| 2021 January | 11 | 18 | 29 |
| 2020 December | 14 | 17 | 31 |
| 2020 November | 4 | 11 | 15 |
| 2020 October | 14 | 9 | 23 |
| 2020 September | 4 | 5 | 9 |
| 2020 August | 7 | 10 | 17 |
| 2020 July | 12 | 15 | 27 |
| 2020 June | 7 | 5 | 12 |
| 2020 May | 14 | 18 | 32 |
| 2020 April | 19 | 24 | 43 |
| 2020 March | 13 | 15 | 28 |
| 2020 February | 21 | 18 | 39 |
| 2020 January | 26 | 19 | 45 |
| 2019 December | 15 | 16 | 31 |
| 2019 November | 9 | 14 | 23 |
| 2019 October | 14 | 12 | 26 |
| 2019 September | 11 | 7 | 18 |
| 2019 August | 8 | 9 | 17 |
| 2019 July | 12 | 15 | 27 |
| 2019 June | 14 | 7 | 21 |
| 2019 May | 9 | 8 | 17 |
| 2019 April | 17 | 14 | 31 |
| 2019 March | 16 | 13 | 29 |
| 2019 February | 13 | 14 | 27 |
| 2019 January | 6 | 9 | 15 |
| 2018 December | 9 | 8 | 17 |
| 2018 November | 22 | 13 | 35 |
| 2018 October | 26 | 28 | 54 |
| 2018 September | 8 | 7 | 15 |
| 2018 May | 2 | 1 | 3 |
| 2018 April | 8 | 6 | 14 |
| 2018 March | 2 | 3 | 5 |
| 2018 February | 6 | 9 | 15 |
| 2018 January | 5 | 7 | 12 |
| 2017 December | 4 | 8 | 12 |
| 2017 November | 6 | 4 | 10 |
| 2017 October | 5 | 5 | 10 |
| 2017 September | 6 | 4 | 10 |
| 2017 August | 9 | 8 | 17 |
| 2017 July | 4 | 4 | 8 |
| 2017 June | 6 | 19 | 25 |
| 2017 May | 5 | 5 | 10 |
| 2017 April | 1 | 1 | 2 |
| 2017 March | 5 | 25 | 30 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 3 | 4 | 7 |
| 2016 December | 8 | 8 | 16 |
| 2016 November | 11 | 5 | 16 |
| 2016 October | 9 | 7 | 16 |
| 2016 September | 18 | 11 | 29 |
| 2016 August | 17 | 6 | 23 |
| 2016 July | 2 | 0 | 2 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 47 | 8 | 55 |
| 2015 September | 55 | 4 | 59 |
| 2015 August | 54 | 6 | 60 |
| 2015 July | 87 | 7 | 94 |
| 2015 June | 48 | 2 | 50 |
| 2015 May | 48 | 6 | 54 |
| 2015 April | 46 | 6 | 52 |
| 2015 March | 38 | 4 | 42 |
| 2015 February | 45 | 2 | 47 |
| 2015 January | 34 | 5 | 39 |
| 2014 December | 46 | 4 | 50 |
| 2014 November | 74 | 4 | 78 |
| 2014 October | 68 | 6 | 74 |
| 2014 September | 38 | 6 | 44 |
| 2014 August | 38 | 9 | 47 |
| 2014 July | 45 | 6 | 51 |
| 2014 June | 57 | 9 | 66 |
| 2014 May | 55 | 8 | 63 |
| 2014 April | 56 | 2 | 58 |
| 2014 March | 60 | 11 | 71 |
| 2014 February | 69 | 8 | 77 |
| 2014 January | 43 | 7 | 50 |
| 2013 December | 40 | 6 | 46 |
| 2013 November | 37 | 6 | 43 |
| 2013 October | 35 | 10 | 45 |
| 2013 September | 43 | 9 | 52 |
| 2013 August | 41 | 8 | 49 |
| 2013 July | 59 | 7 | 66 |
| 2013 June | 33 | 4 | 37 |
| 2013 May | 38 | 4 | 42 |
| 2013 April | 26 | 3 | 29 |
| 2013 March | 9 | 3 | 12 |
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