Prevalence of Chronic Kidney Disease After Heart Transplant: A Single Center Experience

Abstract

Chronic kidney disease (CKD) is a long-term complication after nonkidney solid-organ transplant. The incidence of CKD after heart transplant (HT) ranges between 10% and 80%. With the intention of knowing the prevalence of CKD among patients who have received an HT in our center, as well as the risks factors associated with this complication, we analyzed sociodemographic and laboratory variables, comorbidity, and kidney function of 165 HT recipients between 1986 and 2021 and currently under follow-up in our hospital. We found that 127 of the patients had a CKD Epidemiology Collaboration estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m 2 : 56 patients (33.9%) with CKD stage 2 (eGFR 90-60 mL/min/1.73 m 2 ), 59 (35.8%) with CKD stage 3 (eGFR 59-30 mL/min/1.73 m 2 ) and 16 (9.7%) with GFR <30 mL/min/1.73 m 2 (CKD stage 4-5). Patients with CKD stage 3 were older, with a mean (SD) age of 60.1 (13.9) years ( P = .005), and there was a nonsignificant trend toward a higher proportion of diabetes mellitus (42.4%, P = .059) and a higher prevalence of hyperuricemia (37.3%, P = .008) with respect to the CKD stage 2 group. We found no differences between groups in terms of the prevalence of hypertension, immunosuppressive treatment, or the time elapsed since the transplant. In conclusion, in the analysis of our population of patients with an HT, 3 of 4 have impaired kidney function and more than half have moderate-advanced CKD. Classic risk factors are not different between patients with CKD stage 2 and those with CKD stage 3.