A small retrospective study conducted at Texas Children’s Hospital shows that pediatric lung transplant patients — specifically Caucasian and Hispanic children — seem to be at a greater risk for developing chronic kidney disease (CKD). The study also found that those children with high levels of tacrolimus, an immunosuppressant given to fight organ rejection, circulating in the blood and those who experience at least one episode of acute kidney injury during their recovery also appear to be at a higher risk for CKD.
Lead investigator Maria Gazzaneo, MD, reviewed the medical records of 38 children who received a lung transplant at Texas Children’s Hospital between 2012 and 2014, and two were excluded. Of the 36 remaining subjects, five developed CKD within 1 year of transplantation based on criteria established by an international clinical guideline. Three of the children with CKD were Caucasian and two were Hispanic.
A news release from the American Thoracic Society (ATS) indicates that tacrolimus levels were elevated during the first seven post-operative days in 80% of those who developed CKD, and all patients who developed CKD had at least one episode of acute kidney injury (AKI). Among the children who did not develop CKD, the incidence of AKI was 71%.
Gazzaneo explains, “These results show tendencies that need to be explored further. Still, we believe these results suggest pediatric lung transplantation patients can benefit from renal protective strategies.” Gazzaneo adds, “The patients who developed CKD in our study were adolescents. If we could spare them this complication, it would greatly enhance their quality of life for the rest of their lives.”