KMID : 0359920130320040153
|
|
Korean Journal of Nephrology 2013 Volume.32 No. 4 p.153 ~ p.157
|
|
Clinical usefulness of kidney biopsy in liver transplant recipients with renal impairment
|
|
Lee Jong-Hoon
Cho Yul-Hee Ryu Seung-Jee Kim Sin-Seung Lee Youn-Hee Jang In-Ae Choi Bum-Soon Choi Jong-Young Kim Dong-Goo Choi Yeong-Jin
|
|
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 1.8170.5 mg/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¨ù4), mesangial proliferative GN (n¨ù1), focal proliferative GN (n¨ù1), and membranous GN (n¨ù1). 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 dosewas 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.
|
|
KEYWORD
|
|
Calcineurin inhibitor, Chronic kidney disease, Kidney biopsy, Liver transplantation
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|