ABSTRACT Background Lung transplantation (LTx) is a life‐saving intervention for pediatric patients with end‐stage lung diseases. Understanding its impact on renal function is essential for improving patient management and achieving the primary goals of LTx: enhancing respiratory function, quality of life, and survival. This study analyzes the effect of LTx on renal function in pediatric patients. Methods This retrospective study assessed renal function in 49 children (age range: 1–204 months; median 144 months, IQR 72 months; 26 females, 23 males) who underwent LTx. Renal function was evaluated quantitatively (using glomerular filtration rate, GFR) and qualitatively (using renal scans) before and after LTx. The lowest post‐LTx GFR (post‐LTx LGFR) was the assessment endpoint. GFR decline was analyzed as a percentage reduction from pre‐ to post‐LTx LGFR. The impact of age, sex, primary lung disease, and nephrotoxic medications on GFR decline was also examined. Results The mean pre‐LTx GFR was 151.5 mL/min/1.73 m 2 , while the mean post‐LTx GFR was 81.24 mL/min/1.73 m 2 . A decrease in GFR of more than 25% was observed in 72.09% of patients, with 40.48% experiencing a reduction of more than 50%. The prevalence of impaired renal function (GFR < 90 mL/min/1.73 m 2 ) increased from 11.63% pre‐LTx to 65.31% post‐LTx. Nephrotoxic agents ( p = 0.006) and infections ( p = 0.001) were significant risk factors. Conclusions Lung transplantation significantly reduces renal function in pediatric patients. Frequent renal assessments are recommended for early detection and management of renal impairment, focusing on mitigating nephrotoxic medication and infection risks.
Fard‐Esfahani et al. (Sun,) studied this question.