Rapid Decline in (51)Cr-EDTA Measured Renal Function During the First Weeks Following Lung Transplantation.

Am J Transplant. 2009 May 13. [Epub ahead of print]

Related Articles

Rapid Decline in (51)Cr-EDTA Measured Renal Function During the First Weeks Following Lung Transplantation.

Hornum M, Iversen M, Steffensen I, Hovind P, Carlsen J, Andersen LW, Steinbrüchel DA, Feldt-Rasmussen B.

Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

We previously described a 54% decline in renal function at 6 months after lung transplantation (LTx). We hypothesized that this decline is a very early event following LTx. Thirty-one consecutive patients (16 females/15 males), mean age 49 (+/-13) years, with emphysema, cystic fibrosis/bronchiectasis or idiopathic pulmonary fibrosis were included in an analysis of renal function before and after LTx.

The glomerular filtration rate (GFR) was measured using the (51)Cr-ethylenediaminetetra acetic acid plasma clearance single injection technique (mGFR) at baseline before transplantation and at 1, 2, 3 and 12 weeks postoperatively. Mean mGFR declined from 103 +/- 18 to 65 +/- 22, 53 +/- 16 and 57 +/- 18 mL/min/1.73m(2) at 1-, 3- and 12-weeks post-LTx (p < 0.0001), respectively.

In a time-dependent repeated measures ANOVA, risk factors for a decline in mGFR posttransplant included: time (p < 0.0001), acute renal failure within 2 weeks post-LTx (p = 0.0003), use of heart and lung machine (p = 0.04), and the use of ephedrine (p = 0.048), as well as increasing age, older than 18 years at LTx (p = 0.006). These data demonstrate that renal function, measured with an isotope method, decreases dramatically during the first week after LTx.

PMID: 19459826 [PubMed - as supplied by publisher]

Renal Involvement in Cystic Fibrosis: Diseases Spectrum and Clinical Relevance

Clin J Am Soc Nephrol. 2009 Apr 30. [Epub ahead of print]

Renal Involvement in Cystic Fibrosis: Diseases Spectrum and Clinical Relevance.

Yahiaoui Y, Jablonski M, Hubert D, Mosnier-Pudar H, Noël LH, Stern M, Grenet D, Grünfeld JP, Chauveau D, Fakhouri F.

Department of Nephrology, Université Paris Descartes, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Department of Pulmonology and Adult Cystic Fibrosis Centre and Department of Endocrinology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and INSERM U845, Hôpital Necker, Paris, ||Department of Pulmonology, Hôpital Foch, Suresnes, and paragraph signDepartment of Nephrology and Clinical Immunology, Centre de Référence Maladies Rénales Rares and INSERM U563, Université Toulouse III, CHU Rangueil, Toulouse, France.

BACKGROUND AND OBJECTIVES: Clinically relevant kidney involvement is uncommonly described in adult patients with cystic fibrosis (CF). We sought to report on a series of patients with CF and kidney biopsy-documented renal involvement. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective study was undertaken in two referral centers for adult patients with CF in Paris, France. Patients who had undergone a biopsy of native kidneys between 1992 and 2008 were identified, and their medical records were reviewed. RESULTS: We identified 13 adult patients with CF and renal disease. Proteinuria was present in all but two cases and was associated with progressive renal impairment in four patients (median serum creatinine 85 micromol/L; range 53 to 144 micromol/L). Renal biopsy disclosed a heterogeneous spectrum of nephropathies including AA amyloidosis (n = 3), diabetic glomerulopathy (n = 3), FSGS (n = 2), minimal-change disease (n = 1), postinfectious glomerulonephritis (n = 1), IgA nephropathy related to Henoch-Schönlein purpura (n = 1), membranous nephropathy (n = 1), and chronic interstitial nephropathy (n = 1). Chronic renal failure occurred in five patients, and one patient reached ESRD. CONCLUSIONS: Although rare, clinically significant renal disease may arise in young adult patients with CF. Given the wide spectrum of diseases that may be encountered, definite diagnosis by kidney biopsy is mandatory to optimize clinical treatment of these complex patients, particularly in the perspective of organ transplantation.

PMID: 19406970 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/19406970?dopt=Abstract