Journal article
Clinically adjudicated deceased donor acute kidney injury and graft outcomes
PloS one, v 17(3), pp e0264329-e0264329
2022
PMID: 35239694
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Acute kidney injury (AKI) in deceased donors is not associated with graft failure (GF). We hypothesize that hemodynamic AKI (hAKI) comprises the majority of donor AKI and may explain this lack of association.
In this ancillary analysis of the Deceased Donor Study, 428 donors with available charts were selected to identify those with and without AKI. AKI cases were classified as hAKI, intrinsic (iAKI), or mixed (mAKI) based on majority adjudication by three nephrologists. We evaluated the associations between AKI phenotypes and delayed graft function (DGF), 1-year eGFR and GF. We also evaluated differences in urine biomarkers among AKI phenotypes.
Of the 291 (68%) donors with AKI, 106 (36%) were adjudicated as hAKI, 84 (29%) as iAKI and 101 (35%) as mAKI. Of the 856 potential kidneys, 669 were transplanted with 32% developing DGF and 5% experiencing GF. Median 1-year eGFR was 53 (IQR: 41-70) ml/min/1.73m2. Compared to non-AKI, donors with iAKI had higher odds DGF [aOR (95%CI); 4.83 (2.29, 10.22)] and had lower 1-year eGFR [adjusted B coefficient (95% CI): -11 (-19, -3) mL/min/1.73 m2]. hAKI and mAKI were not associated with DGF or 1-year eGFR. Rates of GF were not different among AKI phenotypes and non-AKI. Urine biomarkers such as NGAL, LFABP, MCP-1, YKL-40, cystatin-C and albumin were higher in iAKI.
iAKI was associated with higher DGF and lower 1-year eGFR but not with GF. Clinically phenotyped donor AKI is biologically different based on biomarkers and may help inform decisions regarding organ utilization.
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Details
- Title
- Clinically adjudicated deceased donor acute kidney injury and graft outcomes
- Creators
- Sherry G Mansour - Yale UniversityNadeen Khoury - Henry Ford Health SystemRavi Kodali - Yale UniversitySarthak Virmani - Yale UniversityPeter P Reese - University of PennsylvaniaIsaac E Hall - University of UtahYaqi Jia - Johns Hopkins UniversityYu Yamamoto - Yale UniversityHeather R Thiessen-Philbrook - Johns Hopkins UniversityWassim Obeid - Johns Hopkins UniversityMona D Doshi - University of MichiganEnver Akalin - Albert Einstein College of MedicineJonathan S Bromberg - University of Maryland, BaltimoreMeera N Harhay - Drexel UniversitySumit Mohan - Columbia UniversityThangamani Muthukumar - Presbyterian HospitalPooja Singh - Thomas Jefferson University HospitalFrancis L Weng - Saint Barnabas Medical CenterDennis G Moledina - Yale UniversityJason H Greenberg - Yale UniversityFrancis P Wilson - Yale UniversityChirag R Parikh - Johns Hopkins University
- Publication Details
- PloS one, v 17(3), pp e0264329-e0264329
- Publisher
- Public LIbrary of Science (PLOS)
- Grant note
- UL1 TR001863 / NCATS NIH HHS R01 DK093770 / NIDDK NIH HHS K23 DK117065 / NIDDK NIH HHS K24 DK090203 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000776002200028
- Scopus ID
- 2-s2.0-85125689221
- Other Identifier
- 991019335319304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology