Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 035] Evaluating the Most Suitable EGFR Equations for Predicting the Risk of End-Stage Renal Disease in Liver Transplant Recipients
Mun Chae CHOI 1, Seung Hyuk YIM 1, Minyu KANG 1, Hwa-hee KOH 1, Young Jin YOO 1, Eun-Ki MIN 1, Deok-Gie KIM 1, Jae Geun LEE 1, Dong Jin JOO 1, Myoung Soo KIM 1
1 Department of Surgery, Severance Hospital, REPUBLIC OF KOREA
Background : End-stage renal disease (ESRD) following liver transplantation (LT) is a pivotal factor in determining long-term patient outcomes. However, there is a lack of research on which eGFR equations are most effective in predicting ESRD. This study aims to evaluate the prognostic accuracy of various eGFR equations in predicting the risk of ESRD in LT recipients.
Methods : We evaluated 1,370 adult LT patients from 2005 to 2022, assessing the risk of ESRD using Fine and Gray's competing risk analysis with death as a competing event. The performances of four eGFR equations (CKD-EPI 2009, CKD-EPI 2021, MDRD4, GRAIL) based on preoperative creatinine levels were compared.
Results : The 5-year, 10-year, and 15-year incidences of ESRD in our cohort were 2.0%, 4.4%, and 9.1%. In the multivariate Cox model, diabetes mellitus (HR 3.59, 95% CI 1.79-7.20, p<0.001) and pre-operative hemoglobin (HR 0.75, 95% CI 0.60-0.93, p=0.010) were significant ESRD risk factors. In the competing risk analysis, adjusting for these factors, only CKD-EPI 2009 and 2021 equations showed increased ESRD risk with advancing CKD stage. Subgroup analysis in patients without pre-transplant dialysis revealed increased ESRD risk with advancing CKD stage in the CKD-EPI 2009 equation [Stage 2 (HR 1.53, 95% CI 1.15-2.02, p=0.003), Stage 3 (HR 1.85, 95% CI 1.28-2.66, p=0.001), Stage 4-5 (HR 2.03, 95% CI 1.19-3.44, p=0.009), using Stage 1 as reference].
Conclusions : The CKD-EPI equations appear to offer a better prediction for post-transplant ESRD, suggesting their potential utility in the preoperative risk stratification of LT recipients.
Methods : We evaluated 1,370 adult LT patients from 2005 to 2022, assessing the risk of ESRD using Fine and Gray's competing risk analysis with death as a competing event. The performances of four eGFR equations (CKD-EPI 2009, CKD-EPI 2021, MDRD4, GRAIL) based on preoperative creatinine levels were compared.
Results : The 5-year, 10-year, and 15-year incidences of ESRD in our cohort were 2.0%, 4.4%, and 9.1%. In the multivariate Cox model, diabetes mellitus (HR 3.59, 95% CI 1.79-7.20, p<0.001) and pre-operative hemoglobin (HR 0.75, 95% CI 0.60-0.93, p=0.010) were significant ESRD risk factors. In the competing risk analysis, adjusting for these factors, only CKD-EPI 2009 and 2021 equations showed increased ESRD risk with advancing CKD stage. Subgroup analysis in patients without pre-transplant dialysis revealed increased ESRD risk with advancing CKD stage in the CKD-EPI 2009 equation [Stage 2 (HR 1.53, 95% CI 1.15-2.02, p=0.003), Stage 3 (HR 1.85, 95% CI 1.28-2.66, p=0.001), Stage 4-5 (HR 2.03, 95% CI 1.19-3.44, p=0.009), using Stage 1 as reference].
Conclusions : The CKD-EPI equations appear to offer a better prediction for post-transplant ESRD, suggesting their potential utility in the preoperative risk stratification of LT recipients.
SESSION
E-poster
E-Session 03/21 ALL DAY