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Article

Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study

by
Junseok Jeon
1,†,
Hyejeong Park
2,†,
Youngha Kim
2,
Danbee Kang
2,
Jung Eun Lee
1,
Wooseong Huh
1,
Eliseo Guallar
2,3,
Juhee Cho
2,* and
Hye Ryoun Jang
1,*
1
Division of Nephrology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul 06531, Korea
2
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
3
Department of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
*
Authors to whom correspondence should be addressed.
†
Junseok Jeon and Hyejeong Park contributed equally to this work as first authors.
J. Clin. Med. 2021, 10(21), 5110; https://doi.org/10.3390/jcm10215110
Submission received: 27 September 2021 / Revised: 26 October 2021 / Accepted: 29 October 2021 / Published: 30 October 2021
(This article belongs to the Section Nephrology & Urology)
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Abstract

Renal dysfunction after heart transplantation (HT) is associated with poor survival. We investigated the predictive factors of renal outcomes after HT using nationwide cohort data. In this retrospective cohort study using the Health Insurance Review and Assessment database of Korea, 654 patients who received HT between 2008 and 2016 and survived until discharge after HT were analyzed. The median (interquartile range) age was 52 (40–60) years, and 68.1% were male. Perioperative renal replacement therapy (RRT) was performed in 27.8% of patients. During 2.8 years of median followup, end-stage kidney disease (ESKD) developed in 12 patients (1.8%). In a fully adjusted model, RRT > 3 weeks, the use of inotropes/vasopressors and non-use of ACEi/ARB were associated with ESKD. Preexisting renal disease tended to be associated with ESKD. Among the 561 patients without preexisting CKD, 104 (18.5%) developed chronic kidney disease (CKD). Age, extracorporeal membrane oxygenation, and RRT were associated with the development of CKD after HT. Our nationwide cohort study demonstrated that perioperative RRT was a predictor of poor renal outcomes after HT. These results suggest that an active renoprotective strategy is required during the perioperative period.
Keywords: chronic kidney disease; end-stage kidney disease; heart transplantation; nationwide cohort; renal outcome chronic kidney disease; end-stage kidney disease; heart transplantation; nationwide cohort; renal outcome

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MDPI and ACS Style

Jeon, J.; Park, H.; Kim, Y.; Kang, D.; Lee, J.E.; Huh, W.; Guallar, E.; Cho, J.; Jang, H.R. Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study. J. Clin. Med. 2021, 10, 5110. https://doi.org/10.3390/jcm10215110

AMA Style

Jeon J, Park H, Kim Y, Kang D, Lee JE, Huh W, Guallar E, Cho J, Jang HR. Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study. Journal of Clinical Medicine. 2021; 10(21):5110. https://doi.org/10.3390/jcm10215110

Chicago/Turabian Style

Jeon, Junseok, Hyejeong Park, Youngha Kim, Danbee Kang, Jung Eun Lee, Wooseong Huh, Eliseo Guallar, Juhee Cho, and Hye Ryoun Jang. 2021. "Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study" Journal of Clinical Medicine 10, no. 21: 5110. https://doi.org/10.3390/jcm10215110

APA Style

Jeon, J., Park, H., Kim, Y., Kang, D., Lee, J. E., Huh, W., Guallar, E., Cho, J., & Jang, H. R. (2021). Prognostic Factors of Renal Outcomes after Heart Transplantation: A Nationwide Retrospective Study. Journal of Clinical Medicine, 10(21), 5110. https://doi.org/10.3390/jcm10215110

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