Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment
Kidney Research and Clinical Practice
; : 153-157, 2013.
Article
em En
| WPRIM
| ID: wpr-197126
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. METHODS: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy. RESULTS: The biopsies were performed at a median of 24.5 months (range, 3-73 months) after liver transplantation. The serum creatinine level was 1.81+/-0.5mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN(n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%).Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%,and 80% of cases, respectively, and mesangial proliferation was detected in 40%of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease. CONCLUSION: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Atrofia
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Esteroides
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Transplante
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Biópsia
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Fibrose
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Estudos Retrospectivos
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Transplante de Fígado
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Calcineurina
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Creatinina
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Diagnóstico
Tipo de estudo:
Diagnostic_studies
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Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Kidney Research and Clinical Practice
Ano de publicação:
2013
Tipo de documento:
Article