Evidence map›Paper›PMID 29399624›Full record

ArticleTransplantation direct2018

Fluctuations of Estimated Glomerular Filtration Rate Outside Kidney Disease Improving Global Outcomes Diagnostic Criteria for Acute Kidney Injury in End-Stage Liver Disease Outpatients and Outcome Postliver Transplantation.

Federica Fiacco, Fabio Melandro, Ilaria Umbro, Assunta Zavatto, Andrea Cappoli, Edoardo Poli, Stefano Ginanni Corradini, Manuela Merli, Francesca Tinti, Italo Nofroni and 3 more

Open access · goldAbstract read
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In one paragraph

Article in Transplantation direct, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact, top 81% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Federica FiaccoNephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Fabio MelandroOrgan Transplant Unit, Department of General Surgery, Sapienza University of Rome, Rome, Italy.
Ilaria UmbroDepartment of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy.
Assunta ZavattoNephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Andrea CappoliNephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Edoardo PoliGastroenterology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Stefano Ginanni CorradiniGastroenterology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Manuela MerliGastroenterology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Francesca TintiDepartment of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy.
Italo NofroniDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Pasquale B BerlocoOrgan Transplant Unit, Department of General Surgery, Sapienza University of Rome, Rome, Italy.
Massimo RossiOrgan Transplant Unit, Department of General Surgery, Sapienza University of Rome, Rome, Italy.
Anna Paola MitterhoferNephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
Sapienza University of Rome · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal dysfunction in end-stage liver disease (ESLD) results from systemic conditions that affect both liver and kidney with activation of vasoconstrictor systems. In this setting, estimated glomerular filtration rate (eGFR) may undergo variations often outside Kidney Disease Improving Global Outcomes criteria for acute kidney injury (AKI) diagnosis, whose meaning is not clear. The aim of this study was to evaluate eGFR variations in ESLD outpatients listed for liver transplant (liver Tx) and the association with post-Tx outcome.

methodsFifty-one patients with ESLD were retrospectively evaluated from listing to transplant (L-Tx time), intraoperatively (Tx time), and up to 5 years post-Tx time. Variations between the highest and the lowest eGFR occurring in more than 48 hours, not satisfying Kidney Disease Improving Global Outcomes guideline, were considered as fluctuations (eGFR-F). Fluctuations of eGFR greater than 50% were defined as eGFR drops (DeGFR). Early graft dysfunction, AKI within 7 days, chronic kidney disease, and short- and long-term patient survivals were considered as outcomes.

resultsAll patients presented eGFR-F, whereas DeGFR were observed in 18 (35.3%) of 51 (DeGFR+ group). These patients presented higher levels of Model for End-stage Liver Disease score, pre-Tx bilirubin and significantly greater incidence of post-Tx AKI stages 2 to 3 compared with patients without drops (DeGFR-). DeGFR was the only independent predictive factor of the occurrence of post-Tx AKI. The occurrence of AKI post-Tx was associated with the development of chronic kidney disease at 3 months and 5 years post-Tx.

conclusionsDrops of eGFR are more frequently observed in patients with a worse degree of ESLD and are associated with a worse post-Tx kidney outcome.

Identifiers

PMID29399624
PMCPMC5777666
OpenAlexW2763114668

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