Differential Characteristics of Kidney Transplant Recipients According to 1-Year Chronic Kidney Disease Stage 3a and Stage 3b Graft Function

Artif Organs. 2017 Apr;41(4):381-391. doi: 10.1111/aor.12753. Epub 2016 Sep 22.

Abstract

The outcomes of transplantation have improved, but more than 50% of kidney transplantation (KT) recipients are still reported to have renal function of chronic kidney disease (CKD) stage 3 at 1 year after KT. We reviewed all 1235 patients who received a KT in our institution between 2008 and 2012. Among these recipients, 77 and 289 cases were included in the estimated glomerular filtration rate (eGFR) at 1 year after KT 30-44 (CKD stage 3b) group and eGFR 45-59 (CKD stage 3a) group, respectively. Longer duration of dialysis (odds ratio [OR] = 1.007, 95% confidence interval [CI], 1.000-1.014, P = 0.047), older donors (OR = 1.064, 95% CI, 1.031-1.098, P < 0.001), delayed graft function (OR = 3.601, 95% CI, 1.031-1.098, P < 0.001), BK virus infection (OR = 2.567, 95% CI, 1.242-5.305, P = 0.011), and pneumonia (OR = 4.451, 95% CI, 1.388-14.279, P = 0.012) were contributing factors to eGFR 30-44 mL/min. Especially, ureteral stricture occurred more frequently in eGFR 30-44 group of deceased donor KT. However, acute rejection was not a significant risk factor of lower eGFR. Graft survival was better in the eGFR 45-59 group. However, this difference was smaller in deceased donor KT. Infections and urologic complications are also important contributing factors of lower graft function in CKD stage 3. In addition, dividing CKD stage 3 into subgroups might be more useful in living donor kidney transplantation.

Keywords: -Chronic kidney disease; -Glomerular filtration rate; -Transplantation; Kidney.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Allografts / pathology
  • Biopsy
  • Delayed Graft Function / epidemiology*
  • Female
  • Glomerular Filtration Rate*
  • Graft Rejection / drug therapy
  • Graft Rejection / epidemiology
  • Graft Rejection / pathology
  • Graft Survival*
  • Humans
  • Immunosuppression Therapy / methods
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Kidney Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Renal Dialysis / statistics & numerical data*
  • Renal Insufficiency, Chronic / surgery*
  • Retrospective Studies
  • Risk Factors
  • Transplant Recipients / statistics & numerical data*
  • Treatment Outcome