Chronic Kidney Disease After Living-donor Liver Transplantation: Prevalence and Predictors.

Background/Aims: Chronic kidney disease (CKD) is a common morbidity in long-term liver transplant recipients. Most of the data are from the deceased-donor liver transplantation (LT) setting; data from living-donor liver transplantation (LDLT) centers are scarce. Methods: The study was conducted at a large-volume LDLT center in North India. A total of 121 patients with a minimum follow-up of 24 months from LT were included prospectively. CKD was considered in the presence of an estimated glomerular filtration rate (eGFR) <60 ml/min for ≥3 months. Data are shown as mean ± standard deviation or median (25-75 interquartile range [IQR]). Results: The study cohort consisted of 112 males and 9 females. The age at transplantation was 48.2 ± 9.4 years; age at inclusion in the study was 53.9 ± 9.9 years. The median follow-up was 5 years (IQR: 3-6 years). A total of 17 (13.4%) patients had an eGFR <60 ml/min at 2 years, and 14 of 17 (11.5%) of these met CKD criteria. The number of patients with an eGFR <60/min was 16 of 94 (17%) at 3 years, 8 of 72 (11.1%) at 4 years, and 8 of 60 (13.3%) at 5 years. The following factors were associated with a diagnosis of CKD at 2 years: higher age and higher creatinine values at the time of LT and a history of acute kidney injury (AKI) before LT. A higher age at LT and a history of AKI remained significant in the multivariate analysis. Conclusion: The prevalence of CKD was 11.5% at 2 years after LDLT. A higher age and a history of AKI before LT were associated with a diagnosis of CKD at 2 years.