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Evolution of association between renal and liver functions while awaiting heart transplant: An application using a bivariate multiphase nonlinear mixed effects model.

Authors
  • Rajeswaran, Jeevanantham1
  • Blackstone, Eugene H1
  • Barnard, John1
  • 1 Department of Quantitative Health Sciences, and Heart and Vascular Institute, Cleveland Clinic, Cleveland, USA.
Type
Published Article
Journal
Statistical Methods in Medical Research
Publisher
SAGE Publications
Publication Date
Jul 01, 2018
Volume
27
Issue
7
Pages
2216–2230
Identifiers
DOI: 10.1177/0962280216678022
PMID: 27856959
Source
Medline
Keywords
License
Unknown

Abstract

In many longitudinal follow-up studies, we observe more than one longitudinal outcome. Impaired renal and liver functions are indicators of poor clinical outcomes for patients who are on mechanical circulatory support and awaiting heart transplant. Hence, monitoring organ functions while waiting for heart transplant is an integral part of patient management. Longitudinal measurements of bilirubin can be used as a marker for liver function and glomerular filtration rate for renal function. We derive an approximation to evolution of association between these two organ functions using a bivariate nonlinear mixed effects model for continuous longitudinal measurements, where the two submodels are linked by a common distribution of time-dependent latent variables and a common distribution of measurement errors.

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