Ischaemic heart disease is a risk factor for renal failure after heart transplantation

Abstract

Background The improvement of a long-term outcomes of heart transplantation (HTx) has resulted in a new phenomenon; specifically, the development of renal dysfunction secondary to calcineurin inhibitor toxicity. This study was designed to assess the participation of risk factors in the development of renal dysfunction in HTx. Methods Data from 310 patients undergoing HTx in our center between 1988–1998 with a post-operation survival period for minimum 5 years ( n = 155) were analyzed retrospectively. Study cohort was divided into two groups according to renal function estimated by serum creatinine in the fifth year (Group I n = 72; serum creatinine ≥ 150 μmol/l, Group II: n = 83, serum creatinine < 150 μmol/l). Results We noted that patients with serum creatinine ≥ 150 μmol/l at 5 years post-HTx had renal function significantly worse as early as 1 month ( p < 0.01), and 1 year post-HTx ( p < 0.001). The risk for developing renal dysfunction after HTx was doubled in patients with a history of coronary artery disease (CAD), and 2.5 times higher in those with small body weight gain. End stage renal disease developed in 16 patients (10.3%) and renal transplantation was performed in 13 (8.4%) of them. Conclusion Our data documented that a history of CAD and limited weight gain is a major risk factor for development of renal dysfunction after HTx. Aggressive modification of risk factors for CAD may reduce the occurrence of this complication.