Congratulations to Levi Bonnell, MPH, Geospatial Specialist and PhD candidate on his latest publication:
Kumar A, Bonnell LN, Thomas CP. Impact of changing renal function, while waiting for a heart transplant, on post-transplant mortality and development of end stage kidney disease. Transpl Int. 2021 Apr 21. doi: 10.1111/tri.13889. Epub ahead of print. PMID: 33884675. https://pubmed.ncbi.nlm.nih.gov/33884675/
Introduction: Heart transplantation is a viable option for end stage heart disease but long-term complications such as chronic kidney disease are being increasingly recognized. We sought to investigate the effect of change in estimated glomerular filtration rate (eGFR) during the heart transplant waitlist period on post-transplant mortality and end stage kidney disease (ESKD).
Methods: We analyzed the United Network of Organ Sharing heart transplant database from 2000-2017. Multivariable Cox regression with restricted cubic splines and cumulative incidence competing risk (CICR) methods were used to compare the effects of change in eGFR on mortality and ESKD, respectively.
Results: 19412 patients met our inclusion criteria. Mortality increased with increasing loss of eGFR (adjusted hazard ratio increased from 1.02 (confidence interval (CI) 1.01-1.04, p=0.008) for 10% loss to 1.15 (CI 1.06-1.26, p=0.001) for 50% loss of eGFR. Similarly, risk of ESKD also increased monotonically with increasing loss of renal function (subdistribution hazard ratio increased from 1.12 (CI 1.09-1.14, p<0.001) to 2.0 (CI 1.74-2.3, p<0.001)) as loss of eGFR increased from 10% to 50%.
Conclusion: Overall, we found that loss of >10% of eGFR resulted in higher risk of mortality and higher risk of ESKD.
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