Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT)

Version 1 : Received: 25 February 2023 / Approved: 27 February 2023 / Online: 27 February 2023 (04:45:33 CET)

A peer-reviewed article of this Preprint also exists.

Viejo-Boyano, I.; López-Romero, L.C.; D’Marco, L.; Checa-Ros, A.; Peris-Fernández, M.; Garrigós-Almerich, E.; Ramos-Tomás, M.C.; Peris-Domingo, A.; Hernández-Jaras, J. Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT). Healthcare 2023, 11, 1760. Viejo-Boyano, I.; López-Romero, L.C.; D’Marco, L.; Checa-Ros, A.; Peris-Fernández, M.; Garrigós-Almerich, E.; Ramos-Tomás, M.C.; Peris-Domingo, A.; Hernández-Jaras, J. Role of the Nephrologist in Non-Kidney Solid Organ Transplant (NKSOT). Healthcare 2023, 11, 1760.

Abstract

Background: Chronic kidney disease (CKD) is a common complication of non-kidney solid organ transplant (NKSOT). Identifying predisposing factors is crucial for an early approach and correct referral to nephrology. Methods: This is a single-center retrospective observational study of a cohort of CKD patients under follow-up in Nephrology Department between 2010 to 2020. Statistical analysis was performed between all the risk factors and four dependent variables: end-stage renal disease (ESKD), increased serum creatinine ≥50%, renal replacement therapy (RRT), and death in pre-transplant, peri-transplant and post-transplant period. Results: 74 patients were studied (7 heart transplant, 34 liver transplants, and 33 lung transplant). Patients who were not followed-up by nephrology in the pre-transplant (p<0.027), peri-transplant (p<0.046), and the longest time until outpatient clinic follow-up (HR 1,032) were associated with a higher risk of creatinine increase ≥50%. Receiving a lung transplant conferred higher risk than liver or hear transplant for developing a creatinine increase ≥50% and ESKD. Peri-transplant mechanical ventilation, peri-transplant and post-transplant anticalcineurin overdose, nephrotoxic and the number of hospital admissions were significantly associated to present a creatinine increase ≥50% and develop ESKD. Conclusion: An early follow-up by the nephrology department was associated with a decrease in the worsening of renal function.

Keywords

chronic kidney disease; solid organ transplant; nephrology

Subject

Medicine and Pharmacology, Urology and Nephrology

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