Acute Kidney Injury as a Complication of Cardiac Transplantation: Incidence, Risk Factors, and Impact on 1-year Mortality and Renal Function Research Paper, Ireland

Since the introduction of the current immunosuppressive therapy, such as calcineurin inhibitors (CNIs), cardiac transplantation has evolved into a life-sustaining treatment for end-stage heart failure with a median survival about 11 years. The downside of this regime are the nephrotoxic effects of CNI usage, which is recognized as one of the most important complications after cardiac transplantation.Previous studies reported that cardiac transplantation recipients are prone for progressive deterioration in renal function which in the worst scenario leads to end-stage renal disease that occurs in up to 20% in the first 10 postoperative years.

Furthermore, cardiac transplantation recipients are at risk for developing acute kidney injury (AKI) in the early postoperative phase. Although AKI is a frequently seen complication and established risk factor for mortality and renal impairment after nontransplantation cardiac surgery, little is known about AKI after cardiac transplantation. Since the first consensus criteria for AKI were published, few studies investigated the incidence of AKI after cardiac transplantation and reported inconsistent results with an incidence ranging from 25% to 70%.

In addition, results regarding the impact of AKI on mortality and renal function are conflicting, probably caused by differences in study design, AKI definition and small sample size. Therefore, we performed a study with the objective to evaluate the early posttransplantation incidence of AKI, defined by the recent published AKI criteria proposed by the Kidney Disease: Improving Global Outcome (KDIGO) group,29 corresponding risk factors and the impact of AKI on mortality and renal function during the first postoperative year.