Variability of the estimated glomerular filtration rate in the first year after kidney transplantation is an independent risk factor for poor renal allograft outcomes: A retrospective cohort study

Hoon Young Choi, Kyu Ha Huh, Jae Geun Lee, Mi Kyung Song, Myoung Soo Kim, Yu Seun Kim, Beom Seok Kim

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2 Citations (Scopus)

Abstract

Renal function in the first year after kidney transplantation (KT) can predict long-term renal graft survival. This study investigated whether estimated glomerular filtration rate (eGFR) variability during the first year after KT is a risk factor for poor renal allograft outcomes. This retrospective cohort study included 3077 patients who underwent repeated eGFR measurements for 1 year after KT at Severance Hospital Transplantation Center between 1979 and 2012. The eGFR variability during the first year after KT was the predictor. The patients were divided into four quartile groups of eGFR variability according to the coefficient of variation for eGFR (eGFR-CV). We selected a cutoff of eGFR-CV for graft failure and performed the sensitivity analyses. The graft outcome was worse in the highest quartile group of eGFR variability than in the other groups among all patients (Q4: HR 1.631, 95% CI 1.278-2.081; p < 0.0001) and among patients without AR (Q4: HR 1.425, 95% CI 1.024-1.982; p = 0.0358) after adjusting for eGFR at 1 year after KT and other covariates. Additionally, allcause mortality was higher in this highest quartile group than in the other groups among all patients but not among patients without AR. Higher eGFR-CVs than the cutoff were significantly associated with a high risk of graft failure among all patients (HR 1.670, 95% CI 1.395-2.000; p < 0.0001) and among patients without AR (HR 1.899, 95% CI 1.457-2.477; p < 0.0001) after fully adjusting for covariates. For all-cause mortality, a higher eGFR-CV was an independent risk factor among all patients but not among patients without AR after adjusting for covariates. eGFR variability in the first year after KT is an independent risk factor for poor renal allograft outcomes.

Original languageEnglish
Article numbere0168337
JournalPloS one
Volume11
Issue number12
DOIs
Publication statusPublished - 2016 Dec

Fingerprint

kidney transplant
allografting
glomerular filtration rate
cohort studies
Glomerular Filtration Rate
Kidney Transplantation
Allografts
Cohort Studies
risk factors
Retrospective Studies
kidneys
Kidney
Grafts
Transplants
Transplantation (surgical)
Mortality
Graft Survival
renal function
Transplantation

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

@article{a610d566c7f340df8d9e499265a7262e,
title = "Variability of the estimated glomerular filtration rate in the first year after kidney transplantation is an independent risk factor for poor renal allograft outcomes: A retrospective cohort study",
abstract = "Renal function in the first year after kidney transplantation (KT) can predict long-term renal graft survival. This study investigated whether estimated glomerular filtration rate (eGFR) variability during the first year after KT is a risk factor for poor renal allograft outcomes. This retrospective cohort study included 3077 patients who underwent repeated eGFR measurements for 1 year after KT at Severance Hospital Transplantation Center between 1979 and 2012. The eGFR variability during the first year after KT was the predictor. The patients were divided into four quartile groups of eGFR variability according to the coefficient of variation for eGFR (eGFR-CV). We selected a cutoff of eGFR-CV for graft failure and performed the sensitivity analyses. The graft outcome was worse in the highest quartile group of eGFR variability than in the other groups among all patients (Q4: HR 1.631, 95{\%} CI 1.278-2.081; p < 0.0001) and among patients without AR (Q4: HR 1.425, 95{\%} CI 1.024-1.982; p = 0.0358) after adjusting for eGFR at 1 year after KT and other covariates. Additionally, allcause mortality was higher in this highest quartile group than in the other groups among all patients but not among patients without AR. Higher eGFR-CVs than the cutoff were significantly associated with a high risk of graft failure among all patients (HR 1.670, 95{\%} CI 1.395-2.000; p < 0.0001) and among patients without AR (HR 1.899, 95{\%} CI 1.457-2.477; p < 0.0001) after fully adjusting for covariates. For all-cause mortality, a higher eGFR-CV was an independent risk factor among all patients but not among patients without AR after adjusting for covariates. eGFR variability in the first year after KT is an independent risk factor for poor renal allograft outcomes.",
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Variability of the estimated glomerular filtration rate in the first year after kidney transplantation is an independent risk factor for poor renal allograft outcomes : A retrospective cohort study. / Choi, Hoon Young; Huh, Kyu Ha; Lee, Jae Geun; Song, Mi Kyung; Kim, Myoung Soo; Kim, Yu Seun; Kim, Beom Seok.

In: PloS one, Vol. 11, No. 12, e0168337, 12.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Variability of the estimated glomerular filtration rate in the first year after kidney transplantation is an independent risk factor for poor renal allograft outcomes

T2 - A retrospective cohort study

AU - Choi, Hoon Young

AU - Huh, Kyu Ha

AU - Lee, Jae Geun

AU - Song, Mi Kyung

AU - Kim, Myoung Soo

AU - Kim, Yu Seun

AU - Kim, Beom Seok

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AB - Renal function in the first year after kidney transplantation (KT) can predict long-term renal graft survival. This study investigated whether estimated glomerular filtration rate (eGFR) variability during the first year after KT is a risk factor for poor renal allograft outcomes. This retrospective cohort study included 3077 patients who underwent repeated eGFR measurements for 1 year after KT at Severance Hospital Transplantation Center between 1979 and 2012. The eGFR variability during the first year after KT was the predictor. The patients were divided into four quartile groups of eGFR variability according to the coefficient of variation for eGFR (eGFR-CV). We selected a cutoff of eGFR-CV for graft failure and performed the sensitivity analyses. The graft outcome was worse in the highest quartile group of eGFR variability than in the other groups among all patients (Q4: HR 1.631, 95% CI 1.278-2.081; p < 0.0001) and among patients without AR (Q4: HR 1.425, 95% CI 1.024-1.982; p = 0.0358) after adjusting for eGFR at 1 year after KT and other covariates. Additionally, allcause mortality was higher in this highest quartile group than in the other groups among all patients but not among patients without AR. Higher eGFR-CVs than the cutoff were significantly associated with a high risk of graft failure among all patients (HR 1.670, 95% CI 1.395-2.000; p < 0.0001) and among patients without AR (HR 1.899, 95% CI 1.457-2.477; p < 0.0001) after fully adjusting for covariates. For all-cause mortality, a higher eGFR-CV was an independent risk factor among all patients but not among patients without AR after adjusting for covariates. eGFR variability in the first year after KT is an independent risk factor for poor renal allograft outcomes.

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