Z Gastroenterol 2009; 47 - P3_55
DOI: 10.1055/s-0029-1191912

Urea but not creatinine or MDRD are predictors for long-term hemodialysis after liver transplantation– retrospective analysis of 211 patients

K Weigand 1, E Bauer 1, J Encke 2, W Stremmel 1, V Schwenger 3
  • 1Abt. Innere Medizin IV, Universitätsklinikum Heidelberg
  • 2Johanna-Etienne-Krankenhaus, Neuss
  • 3Nierenzentrum der Medizinischen Universitätsklinik Heidelberg

Introduction: Outcome and survival rate after liver transplantation have improved. Therefore chronic kidney disease has become increasingly prevalent in this population, despite advances in immunosuppressive regimes and peri-operative management. Since development of chronic kidney disease is associated with enhanced morbidity and mortality combination of liver and kidney transplantation may be an option. The challenge is to identify patients at time of liver transplantation that would profit from combined transplantation.

Patients and Methods: 211 liver transplant recipients were retrospectively analyzed with respect to creatinine, urea, MDRD and need of hemodialysis. In addition, underlying liver disease and immunosuppressive protocol was correlated to necessity of hemodialysis 3 month after liver transplantation. Patients undergoing liver transplantation from 1/2004 to 12/2006 were included in this study.

Results: Laboratory and clinical parameters were analyzed at time of liver transplantation. Patients in need of hemodialysis at liver transplantation and/or 3 month after were compared in respect of creatinine, urea and albumin in sera. No significant differences were found between patients undergoing hemodialysis and patients without in terms of creatinine, albumin and MDRD. However, when comparing urea, a significant difference was seen (p=0.032). Comparison of underlying liver disease and immunosuppressive regime identified no significant difference between patients with hemodialysis three month after liver transplantation and patients with or without hemodialysis at time of transplantation. In addition, patients with necessity of hemodialysis three month after liver transplantation had an increased mortality rate that almost reached significance (p=0.075).

Conclusion: Urea is the only identified predictor for long-term need of hemodialysis in liver transplant recipients. These patients have an increased risk of mortality.

MDRD - chronic kidney disease - creatinine - liver transplantation - urea