There are no differences in distribution of risk factors among living adult liver transplant recipients 1-year post-transplant by CKD status.
Chart Explanation: The x-axis shows the CKD status of adult (age > 21 years) liver transplant recipients at 1-year post-transplant. Categories included are CKD/ESRD or not CKD.
The y-axis shows the percentage of adult liver transplant recipients at 1-year post-transplant that fall within each of the categories listed on the x-axis.
Individuals who received a solid organ transplant in the United States were followed up annually on the anniversary of the transplant date for an assessment of their health status. These data were recorded in the Scientific Registry of Transplant Recipients (SRTR). All analyses presented are limited to adults aged 20 years or older at the time of their first organ transplant. Diabetes status (type 1 or 2) and hypertension status are as listed at the time of transplant. For all transplant recipients, use of calcineurin inhibitors (CNI) to prevent transplant rejection is presented as many of these medications have been shown to be nephrotoxic1. The recording of data in the SRTR pertaining to CKD/kidney function varied by organ type and is discussed below.
Liver transplant data included serum creatinine measurements for each follow-up but do not report whether patients went on dialysis or had a kidney transplant since their last visit. A liver transplant recipient is defined as having CKD or ESRD if he/she has Chronic Kidney Disease Epidemiolgy Collaboration (CKD-EPI) equation estimated GFR <60 ml/min/1.73 m². Donor type (deceased vs. living) information is provided for liver transplant recipients.
1Ojo AO. Renal disease in recipients of nonrenal solid organ transplantation. Semin Nephrol.2007;27(4):498-507.
|Description of Measure||Prevalence of CKD (by eGFR) and Renal Dysfunction|
|Data Source||Scientific Registry of Transplant Recipients|
|Type of Data Source||Registry|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Solid Organ Transplant Recipients|
|Numerator||Patients in denominator with eGFR<60 (Liver, Kidney) or ‘renal dysfunction’ (Thoracic) at time of follow-up.|
|Denominator||Patients with a valid follow-up code who had a first solid organ transplant between 2006 and 2016 and were at least 20 years old at time of transplant.|
|Definition of diagnosed CKD||Stage 3, eGFR 30-59 ml/min per 1.73 m² Stage 4, 15-29 ml/min per 1.73 m²
Stage 5, <15 ml/min per 1.73 m²|
|Glomerular filtration rate|
Estimated using CKD-EPI formula for calibrated creatinine:
GFR = 141 × min (Scr /κ, 1)α × max(Scr /κ, 1)-1.209 × 0.993Age × 1.018 [if female] × 1.159 [if black]
|Primary Data Source Indicator||Serum Creatinine measurements/Renal Dysfunction indicator|
|Primary Indicator Method of Measurement||Transplant follow-up|
|Secondary (1) Variable||Type of organ transplant|
|Secondary (1) Variable Method of Measurement||Registry|
|Secondary (2) Variable||Age|
|Secondary (2) Variable Method of Measurement||Registry|
|Secondary (3) Variable||Race/ethnicity|
|Secondary (3) Variable Method of Measurement||Registry|
|Secondary (4) Variable||Gender|
|Secondary (4) Variable Method of Measurement||Registry|
|Secondary (5) Variable||Diabetes|
|Secondary (5) Variable Method of Measurement||Registry|
|Secondary (6) Variable||Hypertension|
|Secondary (6) Variable Method of Measurement||Registry|
|Secondary (7) Variable||Calcineurin Treatment|
|Secondary (7) Variable Method of Measurement||Registry|
|Secondary (8) Variable||Expanded Criteria Donor Status|
|Secondary (8) Variable Method of Measurement||Registry|
|Frequency of Measurement (Primary)||Multiple measurements per patient|
|Period Currently Available|
|Additional Data Items of Interest||Trends over time, other stratification variables of interest.|
|Limitations of Indicator||Reporting of data across organ types is not consistent. Reporting of kidney function for thoracic recipients may be subjective. Serum creatinine measurements are only taken once per follow-up, probably resulting in a large standard error.|
|Analytical Considerations||Missing data on serum creatinine measurements may be informative.|