Prognostic Value of Creatinine Concentration and Glomerular Filtration Rate in Acute Kidney Injury Development in the Early Postoperative Period After Heart Transplantation.

INTRODUCTION

Recipients of nonrenal organ transplants, including the heart, are at risk for developing acute kidney injury (AKI). This situation significantly jeopardized the outcome of patients. The most effective treatment is continuous renal replacement therapy (CRRT) AIM: The goal of this project is to verify the prognostic value of preoperative serum creatinine concentration and glomerular filtration rate (GFR), calculated by the Modification of Diet in Renal Disease formula, to determine the risk of renal failure after grafting

RESULTS

In the group of 39 patients, CRRT was needed in 7 patients (17.9%; group K); 32 patients were in the control group (group C). The pretransplant creatinine level in group K was 133.7 ± 31.3 μmol/L and in group C was 160.8 ± 97.6 μmol/L; P = .47. We did not find a difference between groups in GFR: group K 51 ± 6mL/min/1.73 m2 versus group C 43 ± 20 mL/min/1.73 m2; P = .65. Demographic data differed between groups. Patients in group C had significantly more often hypertension, diabetes mellitus, ischemic cardiomyopathy, and previous neurologic disorders and were male. Patients with CRRT had longer intensive care unit (ICU) stays after transplantation than the control population: 25 ± 19 versus 12 ± 10 days; P = .02. Other results showed that primary graft dysfunction occurred in 2 patients in group K and 6 in the control group; 1 needed extracorporeal membrane oxygenation support, and he died on the 12th day. The mean duration of renal replacement therapy was 9.8 days. There were 2 neurologic disorders-1 in each group-and 6 reoperations due to bleeding.

CONCLUSIONS

Developing AKI requiring CRRT after heart transplantation prolonged the length of ICU stays. Preoperative creatinine concentration and glomerular filtration rate do not predict AKI.