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Incidence and outcomes of acute kidney injury following orthotopic lung transplantation: a population-based cohort study.

dc.contributor.authorFidalgo, P
dc.contributor.authorAhmed, M
dc.contributor.authorMeyer, S
dc.contributor.authorLien, D
dc.contributor.authorWeinkauf, J
dc.contributor.authorCardoso, F
dc.contributor.authorJackson, K
dc.contributor.authorBagshaw, S
dc.date.accessioned2015-08-24T15:52:55Z
dc.date.available2015-08-24T15:52:55Z
dc.date.issued2014
dc.description.abstractBACKGROUND:Acute kidney injury (AKI) is a serious complication following lung transplantation (LTx). We aimed to describe the incidence and outcomes associated with AKI following LTx. METHODS: A retrospective population-based cohort study of all adult recipients of LTx at the University of Alberta between 1990 and 2011. The primary outcome was AKI, defined and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, in the first 7 post-operative days. Secondary outcomes included risk factors, utilization of renal replacement therapy (RRT), occurrence of post-operative complications, mortality and kidney recovery. RESULTS: Of 445 LTx recipients included, AKI occurred in 306 (68.8%), with severity classified as Stage I in 38.9% (n = 173), Stage II in 17.5% (n = 78) and Stage III in 12.4% (n = 55). RRT was received by 36 (8.1%). Factors associated with AKI included longer duration of cardiopulmonary bypass [per minute, odds ratio (OR) 1.003; 95% confidence interval (CI), 1.001-1.006; P = 0.02], and mechanical ventilation [per hour (log-transformed), OR 5.30; 95% CI, 3.04-9.24; P < 0.001], and use of cyclosporine (OR 2.03; 95% CI, 1.13-3.64; P = 0.02). In-hospital and 1-year mortality were significantly higher in those with AKI compared with no AKI (7.2 versus 0%; adjusted P = 0.001; 14.4 versus 5.0%; adjusted P = 0.02, respectively). At 3 months, those with AKI had greater sustained loss of kidney function compared with no AKI [estimated glomerular filtration rate, mean (SD): 68.9 (25.7) versus 75.3 (22.1) mL/min/1.73 m(2), P = 0.01]. CONCLUSIONS: By the KDIGO definition, AKI occurred in two-thirds of patients following LTx. AKI portended greater risk of death and loss of kidney functionpor
dc.identifier.citationNephrol Dial Transplant. 2014 Sep;29(9):1702-9por
dc.identifier.doi10.1093/ndt/gfu226
dc.identifier.urihttp://hdl.handle.net/10400.10/1514
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherEuropean Dialysis and Transplant Association, European Renal Association.por
dc.subjectAcute kidney injurypor
dc.subjectLung transplantationpor
dc.subjectPostoperative complicationspor
dc.subjectIncidencepor
dc.titleIncidence and outcomes of acute kidney injury following orthotopic lung transplantation: a population-based cohort study.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceOxfordpor
oaire.citation.endPage1709por
oaire.citation.startPage1702por
oaire.citation.titleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.por
oaire.citation.volume29por
rcaap.rightsclosedAccesspor
rcaap.typearticlepor

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