Increased Incidence of Chronic Kidney Injury in African Americans Following Cardiac Transplantation.

Abstract

This study examined whether African American race was associated with an elevated risk of chronic kidney disease (CKD) post-cardiac transplantation. CKD often occurs after cardiac transplantation and may require renal replacement therapy (RRT) or renal transplant. African American patients have a higher risk for kidney disease as well as worse post-cardiac transplant morbidity and mortality. It is unclear, however, if there is a propensity for African Americans to develop CKD after cardiac transplant. The Institutional Review Board of Columbia University Medical Center approved the retrospective study of 151 adults (57 African American and 94 non-African American) who underwent single-organ heart transplant from 2013 to 2016. The primary outcome was a decrease in estimated glomerular filtration rate (eGFR), development of CKD, and end-stage renal disease (ESRD) requiring RRT after 2years. African American patients had a significant decline in eGFR post-cardiac transplant compared to non-African American patients (- 34 ± 6 vs. - 20 ± 4mL/min/1.73m2, p < 0.0006). African American patients were more likely to develop CKD stage 2 or worse (eGFR < 90mL/min/1.73m2) than non-African American patients (81% vs. 59%, p < 0.0005). This is the first study to report that African American patients are at a significantly higher risk for eGFR decline and CKD at 2years post-cardiac transplant. Future investigation into risk reduction is necessary for this patient population.